Cost of a full thyroid panel v TSH alone

[asiatic]

We often hear of patients being refused a full thyroid panel due to cost. Can anyone tell me the cost differential to the NHS as I suspect it may be minimal.

[pennyannie]

Hello Asiatic :

There was a post on this a few years ago and believe it talked of 91 pence per blood analysis :

[asiatic in reply to pennyannie]

I seem to remember reading it was under a pound. Surely a small price to pay and no justification for refusing a full panel on basis of cost

[pennyannie in reply to asiatic]

Since T3 / NDT not routinely prescribed and in some areas of the country a total No No -

I guess the relevance of a full thyroid panel lost -

as should you know how to read and interpret the blood test - but have no treatment option other than T4 - what is the point of knowing ?

Reminds me of the 3 blind monkeys - as opposed to the 3 wise men !

[Hedgeree]

I don't think it's really refused on a cost basis but more that it could highlight the person's need for T3 replacement. I think the 'cost' of FT3 test is used as an excuse.

[asiatic in reply to Hedgeree]

I would like to be prepared with the facts on cost to preempt this ever being used as yet another ( wrong ) arguement for only doing TSH.

[Hedgeree in reply to asiatic]

Yes I totally agree.

[helvella Administrator]

I suggest you put in a Freedom of Information request to your Integrated Care Board (or whatever relevant organisation applies for you).

The costs could vary significantly from one lab, one ICB area, one nation, to another. Among other things it will depend on which analyser technology they use and their contract for the supplies.

Remember to request, specifically, the incremental costs of FT4 and FT3 (individually and together) when added to an existing TSH test. That is, it is important to exclude things like the cost of the appointment for blood draw, the actual phlebotomy, transport to lab, etc. which apply regardless the tests being done. (I think TSH, FT4 and FT3 can always be done on the same sample. Other tests might require multiple tubes which has another cost impact.)

If you wade in with a number from another area, and a few years old, it won't do much for your case. But if you have bang up to date costs that are directly applicable to you, that is a much stronger starting position.

[jimh111 in reply to helvella]

Certainly submit an FOI request, see mine below. Prices differ substantially from less than £1 to around £3 or £4, there were examples in a NICE? document some time ago. In business private companies benchmark costs, compare what others are paying in the market. If they find they are paying a few percent more than the cheapest they hammer the supplier. The NHS just can't be bothered to save money, it's disgraceful.

[TSH110 in reply to jimh111]

So we are not even worth £4 at the highest end of the cost variable. It’s good to know just how worthless I am

[asiatic]

Thank you helvella for such an informative answer. I will look into doing a Freedom of information request and post any reply I receive.

[jimh111]

London North West Healthcare NHS Trust is responding to your Freedom of Information request received on 28/07/2017.

FOI Ref: 1003-17

You asked:

The cost of a TSH and fT4 assay.

The cost of a combined TSH, fT3, fT4 assay.

To clarify, I'd like the net fee paid to The Doctors Laboratory to carry out each of the two assays.

---------------------

In response: TSH cost £0.90, fT3 £0.92, fT4 £0.92

These costs are set whether they are combined or ordered separately, just added together as per order.

[asiatic in reply to jimh111]

Thank you jimh111. So am I interpreting it correctly that in your area TSH costs £0.90 and a full panel would be £2.74 ? I have sent a FOI request to my health authority and will post their reply

[jimh111 in reply to asiatic]

That's right and it shows how much we are ripped off for private tests. Your area will probably pay more but see Table 2 here ncbi.nlm.nih.gov/books/NBK5... .

TFT Costs

[TSH110 in reply to jimh111]

We can’t access their economies of scale yet we are their patients not feeling well on their medicine and have to pay through the nose to try and get well again it’s not a health service it’s an illness service