Summary: Radiofrequency ablation (RFA) is a cost-effective, minimally invasive alternative to thyroidectomy for benign thyroid nodules. Studies show that RFA costs 55% less, has fewer complications, and offers better long-term value.
- RFA vs. Surgery: RFA is non-surgical, outpatient, and less invasive. Surgery requires hospitalization, general anesthesia, and longer recovery.
- Cost Comparison: RFA costs $8,726 vs. $19,229 for surgery, mainly due to lower personnel and hospital costs.
- Complications: Thyroidectomy has higher risks, including infection, nerve injury, and hormone dependence.
- Cost-Effectiveness: RFA remains cost-effective as long as it stays below $17,950 per procedure.
- Overhead Reduction: RFA lowers hospital-related costs by 50% by eliminating OR fees and anesthesia.
For years, thyroidectomy has been the dominant approach for the treatment of benign thyroid nodules. However, radiofrequency ablation (RFA), a minimally invasive, in-office alternative, is gaining prominence. With a large and growing evidence base supporting the procedure’s efficacy, it’s gaining popularity with clinicians worldwide. The introduction of insurance reimbursement through a new CPT code makes RFA even more accessible for patients and practitioners.
Like many decisions, the ablation vs surgery debate often comes down to cost-effectiveness. Is offering radiofrequency ablation in your practice a wise financial decision?
Most research agrees that if RFA remains below a certain cost threshold, it is the better option for most patients. This is due to its lower risk, quicker recovery, and significantly lower total costs. Likewise, upon adoption, clinicians can anticipate higher patient satisfaction and a significant increase in ROI.
In this blog, we’ll share the findings of recent studies on the cost-effectiveness of excision surgery vs ablation. Continue reading to learn the data behind each.
Is Radiofrequency Ablation Considered Surgery?
Radiofrequency ablation is not surgery. Instead, it is considered a non-surgical alternative to thyroidectomy. Ultimately, RFA and surgery differ significantly in invasiveness, recovery time, and setting.
Invasiveness
Radiofrequency ablation is performed without incisions and typically does not require general anesthesia. In contrast, thyroidectomy involves making an incision in the neck to remove part or all of the thyroid gland. It is a major surgical procedure performed in an operating room under general anesthesia.
Recovery Time & Setting
RFA is performed in an outpatient setting. Patients can typically go home the same day with minimal recovery time. In contrast, surgery typically requires hospitalization, and recovery can take several weeks due to the incision and potential complications.
Risks & Complications
Thyroidectomy carries higher risks compared to RFA. Most studies report an overall complication rate of 2.38% for RFA, with major complications accounting for 1.35%.
Potential complications, risks, and considerations of surgery include:
- Infection
- Recurrent laryngeal nerve injury (up to 7.2% of cases)
- Hypothyroidism and the need for lifelong thyroid hormone replacement (Up to 30% of cases)
- Hypoparathyroidism (Up to 16.7% of cases)
Ultimately, radiofrequency ablation is not a surgery. That alone makes it a safer and more appealing treatment option for many patients.
Thyroid Ablation vs Surgery: Comparing Cost-Effectiveness
Two recent studies provide valuable insights into how radiofrequency ablation compares to thyroidectomy surgery in terms of cost, efficiency, and patient outcomes.
The first is If the Price is Right: Cost-effectiveness of RFA vs. Thyroidectomy in the treatment of benign thyroid nodules led by Dr. Eric J. Kuo and colleagues at Columbia University (2023). This study compares cost-effectiveness using quality-adjusted life years (QALYs) and overall cost.
We’ll also look at Time-Driven Activity-Based Cost Comparison of Thyroid Lobectomy and Radiofrequency Ablation led by Dr. Noel F. Ayoub and colleagues (2023). This study breaks down procedure costs into categories, including personnel, consumables, and overhead expenses.
Both studies provide a compelling financial argument in favor of RFA over thyroidectomy. We’ll provide the key insights below.
Ablation vs Surgery: Comparing Overall Costs
According to a time-driven activity-based cost analysis, RFA is significantly more cost-effective than thyroid lobectomy.
On average, RFA costs about 55% less than thyroidectomy. The total cost of thyroidectomy came out to $19,229.75 compared to RFA, which cost an average of $8,726.38 overall. In thyroidectomy, the largest cost drivers are operating room costs, anesthesia, and postoperative hospital stays. None of those elements are necessary for RFA.
Additionally, a cost-effectiveness study comparing quality-adjusted life years (QALYs) found that RFA yields better long-term value. The study found that thyroidectomy yielded 21.13 QALYs, and RFA yielded 21.31 QALYs. That makes the cost per QALY $912 per year for surgery and $778 per year for RFA. Thus, RFA emerges as the dominant cost-effective strategy.
Ablation vs Surgery: Comparing Procedure Costs by Category
Surgical lobectomy costs more in personnel and facility overhead. That is due to the need for an operating room, multiple staff members, and general anesthesia.
Compare the following personnel requirements:
- Total Personnel Cost: $1,087.97 for surgery and $379.90 for RFA
- Surgeon’s Time: 132 minutes for surgery and 60 minutes for RFA
- Anesthesiologist: Required for surgery, not required for RFA
- Nurses and Support Staff: Surgery requires an operating room team, while RFA requires a small outpatient staff
According to Ayoub et al., choosing RFA over surgery reduces overall personnel costs by nearly 65%.
The study also compared the overhead costs associated with each procedure. Researchers found that the total overhead cost for thyroidectomy was $17,199.10. Compare that to $7,031.20 for RFA.
Factors include the need for anesthesia and a post-op hospital stay. Plus, clinicians must factor in facility fees for the use of a hospital surgical suite. RFA does not require anesthesia or a hospital stay and is performed in an outpatient setting.
Ultimately, the ability to perform RFA in a clinic rather than a hospital alone reduces overhead costs by more than 50%.
Key Insights
Both studies confirm that RFA is the superior choice from a cost perspective. As long as RFA remains under $17,950 per procedure, it produces comparable or better patient outcomes at a lower cost.
According to the studies referenced:
- RFA is 55% cheaper than thyroidectomy due to lower overhead and personnel costs.
- The single-use RFA probe is the biggest cost associated with the procedure. However, it is far outweighed by savings in other areas.
- Thyroidectomy has significantly higher hospital-related expenses. That makes it a less cost-effective option for benign nodules.
Optimize Cost-Effectiveness with Radiofrequency Ablation
This is the perfect time to begin providing Radiofrequency Ablation to your patients. Connect with STARmed America to learn how utilizing electrodes with adjustable active tips, such as the VIVA II, allows for the treatment of multiple nodule sizes with a single electrode.
