Low Iodine in Germany

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Cost over 1 Billion Dollars!! in thyroid issues.

Buist, ND

THYROID

Volume 12, Number 10, 2002

© Ann Liebert, Inc.

Cost Estimation of Thyroid Disorders in Germany

J. Kahaly1 and Markus Dietlein2

To assess the economic effects of thyroid disorder-related morbidity in Germany, a systematic review of national

and international literature from 1981–2001 was performed. Data from insurance companies, the government

department of public health, and the federal office of statistics helped characterize the situation in Germany.

Being the most important thyroid disease, endemic iodine-deficiency goiter causes economic costs of

approximately 2.1 billion DM per year or 1 billion Euros ( ) or 1 billion U.S. dollars. In recent years iodine supplementation

of food became better accepted by the German population. This should significantly reduce the

prevalence of goiter from 30%–40% to less than 10%. Functional thyroid disorders are observed in 5%–10% of

the German population. A more differentiated view of these conditions should lead to specific guidelines for

an economic screening and therapy of subpopulations. Lacking valuable data, an actual economic assessment

of autoimmune or malignant thyroid diseases cannot be performed. On the other hand, with respect to the costs

of specific thyroid therapy, e.g., radioiodine treatment of thyrotoxicosis (mainly toxic nodular goiter), the economic

consequences of a new regulation for radiation protection in Germany have been demonstrated recently.

Using the actual maximum permissible level of residual activity on discharge from the hospital after radioiodine

therapy, length of hospitalization was shortened to 5.1 days in university hospitals and to 5.8 days in

nonuniversity institutions. Payment per patient for radioiodine therapy was 1856 and 1530 (median value)

in university and nonuniversity hospitals, respectively. In conclusion, better prevention of iodine deficiency

and its long-term consequences should effectively reduce direct as well as indirect costs and overall economic

impact of endemic goiter as the most important thyroid disease in Germany. Sustainable elimination of iodine

deficiency is technically possible, but it needs further commitment and support at all levels.

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IDD costs Germany.pdf