Managing persistent post-surgical hypoparathyroidism in Italy costs between roughly €5,750 and €5,768 per patient in the first year when the condition runs its course without complications, rising to about €9,649 to €9,667 when complications occur, according to a new micro-costing and cost-comparison analysis published in the journal Cost Effectiveness and Resource Allocation. The figures include the initial assessment, annual follow-up, drug treatment with a conventional regimen, and estimated productivity losses.
Because evidence on the economic burden of this rare chronic endocrine disorder within the Italian health system has been limited, the authors set out to estimate direct and indirect costs of managing the condition, stratified by patient subgroup, treatment strategy, complication status, and pregnancy-related care.
The second, PICO 2, covered pregnancy and the first three months postpartum, a care pathway the authors note has been particularly under-documented in economic terms.
The component costs reveal where the money goes. A one-off initial assessment was costed at €327.43 per patient. Annual follow-up differed by subgroup: €223.85 for men and women of childbearing age, and €206.29 for postmenopausal women, reflecting differences in monitoring needs.
The analysis also modelled parathyroid hormone replacement scenarios. The component cost of palopegteriparatide was estimated at €32,197.80 for six months of treatment. A historical reference scenario using recombinant human PTH 1–84 was costed at €39,262.50 for four months and retained solely for comparison. When palopegteriparatide was assumed to be given alongside unchanged conventional treatment, first-year total costs without complications rose to €37,947.93 to €37,965.49.
The authors are careful about what these numbers do and do not show. In their conclusions, they state that PTH replacement scenarios had higher modelled drug costs than the conventional regimen, but that acquisition costs alone cannot determine relative value or cost-effectiveness. They call for comparative clinical outcomes and Italian real-world resource-use data to inform future health technology assessments. This is a modelling exercise based on expert-panel estimates rather than observed patient-level costs, and the published figures are described as estimates of selected per-patient management costs and productivity losses.
Pregnancy and early postpartum care formed a distinct part of the analysis. Over pregnancy and the first three months postpartum, estimated direct costs and productivity losses totalled €3,036.04, excluding pharmacological treatment and the initial assessment. Within that total, maternal follow-up accounted for €1,038.71 and neonatal follow-up for €353.55. Productivity losses represented approximately 54 percent of this pregnancy-related total, a reminder that indirect costs weigh heavily in this condition. The analysis does not cover the full duration of breastfeeding, a limitation the authors flag explicitly.
The cost structure of the first year is driven by more than drugs. With the conventional regimen and no complications, first-year totals of €5,750.13 to €5,767.69 include the initial assessment and estimated productivity losses, while the presence of complications pushes the range to €9,649.38 to €9,666.94.
For health systems weighing how to manage this patient population, the study offers a structured baseline: conventional care carries moderate annual drug costs but meaningful first-year totals once assessments and productivity losses are counted, hormone replacement scenarios carry far higher acquisition costs whose value remains unproven in the Italian setting, and pregnancy-related care generates costs that extend beyond the mother to the newborn. The authors position their estimates as a starting point for future Italian health technology assessments, pending real-world data on both resource use and clinical outcomes.
Subject of Research: Micro-costing of direct and indirect costs of managing persistent post-surgical hypoparathyroidism in Italy, including pregnancy and early postpartum care
Article Title: A micro-costing and cost-comparison analysis based on Italian guidelines for the management of persistent post-surgical hypoparathyroidism, including pregnancy and early postpartum care
Article References: Basile, M., Brandi, M. L., Chiodini, I., Mantovani, G., Palermo, A., Sorrenti, S., Vescini, F., Biamonte, E., Cianferotti, L., D’Aurizio, F., Eller-Vainicher, C., Galassi, A., Giusti, F., Manganaro, N., Montagnani, A., Naciu, A. M., Paoletti, A. M., Pigoni, A., Pizzini, A., … Valentini, I. (2026). A micro-costing and cost-comparison analysis based on Italian guidelines for the management of persistent post-surgical hypoparathyroidism, including pregnancy and early postpartum care. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00852-8
Image Credits: AI Generated
DOI: 10.1186/s12962-026-00852-8
Keywords: post-surgical hypoparathyroidism, micro-costing, cost analysis, Italian National Health Service, parathyroid hormone replacement, palopegteriparatide, pregnancy, postpartum care, productivity losses, Activity-Based Costing, health technology assessment, rare endocrine disorder
News Source: Courtney Benton. (October 27, 2026). Italian study estimates yearly costs of managing persistent post-surgical hypoparathyroidism. Scienmag.
