What is the cost to the NHS of TSH / T4 / T3 tests? Where can I send an FOI to?

[TaraJR]

A while ago someone had done an FOI to find out the cost of TSH, T4 and T3 tests.

@jimh111 I think it may have been you?

Where did you send your FOI? I'd like to do the same for current costs, but I'm not sure where to send it.

[Buddy195 Administrator]

jimh111

I don’t think your shout out will work TaraJR, as it’s not blue

[jimh111]

healthunlocked.com/thyroidu... . There was also a document about liothyronine prescribing that showed similar but a little higher costs. Can't remember what it is.

[helvella Administrator]

Bear in mind that every single Integrated care system (ICS) in England could have different costs. Indeed, each lab within a single ICS might have different costs.

(And Northern Ireland, Scotland and Wales would each need to be considered in their own right.)

The testing costs which were published around the same time as the NICE NG145 guidance were appalling. Inconsistent basis for costs and it looked as if each of the sources had a word with their lab and took the costs at face value.

I think you need to ask each ICS individually in order to put yourself in the position of being able to discard outliers. And, though I don't know for sure, it would probably be best to ask the actual ICS rather than the labs themselves.

I think the fundamental requirement is to establish the incremental cost of doing FT4 on top of TSH, and FTY3 on top of TSH+FT4. But if that were policy, the cost of both FT4 and FT3 could be expected to drop because they become as common as TSH.

[helvella Administrator in reply to helvella]

Some information which is of exceptionally poor quality from the NG145 evidence.

National Institute for Health and Care Excellence

FINAL

Thyroid disease:

assessment and

management

[C] Thyroid function tests

NICE guideline

Intervention evidence review underpinning recommendations

1.2.8 to 1.2.10 in the guideline

2019

nice.org.uk/guidance/ng145/...

Screenshot from linked document

[helvella Administrator in reply to helvella]

Based on the document I calculated costs of testing.

It appears to me that cost of all three at D are lower than TSH only at A, and lower than TSH+FT4 at every other lab.

The reasons for this should have been investigated - not relegated to an obscure evidence addendum.

Screenshot of my spreadhseet

[asiatic in reply to helvella]

So not much difference in cost between measuring TSH with fT4 and measuring fT4 and fT3 together. Given that I know my TSH is always low perhaps I can save them some money by requesting they measure the two thyroid hormones - much more useful - letting me check where they are in range and their ratio. 😇

[jimh111 in reply to helvella]

This is the table I was thinking of. It's dreadful. All businesses benchmark costs and insist their suppliers price match. The NHS couldn't care less we what they pay.

[asiatic]

I live in Scotland. A couple of years ago I put a FOI request to my local health authority. I was gathering info to support having fT3 measured as I suspected the incremental cost wasn't much. The answer I received back was that they didn't have this information. They can't therefore use cost as an excuse when they don't know the extra cost. Surely it is the duty of a health authority to know what they are paying and be able to compare with other regions. From the little info I did find there seemed to be huge disparities.

[serenfach]

I looked into this ages ago, and then the price difference was 90p to add T3 when testing TSH and T4. I will see if I can find it, but am helping my daughter move house, so am walking in small circles, gibbering...

Next week I am stripping...

wallpaper. What were you thinking?