Communication of Cost in Thyroidectomy: A Mixed-Methods Analysis of Financial Toxicity

Sunday, October 12, 2025

2:48 PM - 2:54 PM EDT

Location: 128

Disclosure(s):

Derek D. Kao, MD, MSCR:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Financial toxicity is common among surgical patients and can lead to adverse economic and health outcomes, yet little is known about patient preparedness. We assessed the cost information given to patients undergoing thyroidectomy.

Methods: This explanatory sequential mixed methods study recruited adults who underwent thyroidectomy between 1/2021 and 1/2024 at a tertiary-care center. Financial toxicity was measured using a validated survey tool. Semi-structured interviews explored patient experiences through qualitative content analysis.

Results: Of 623 eligible patients, 180 completed surveys and 167 were analyzed. Most participants were female (78%) and white (84%). The majority underwent total thyroidectomy (65.3%) and 31% experienced moderate-severe financial toxicity. 61% reported being “not at all” or “a little bit” informed about costs related to their thyroid care. 20% sought cost information before surgery, primarily from their insurance carrier (82.4%).

In interviews (n=20), almost all patients recalled no discussion of cost with their treatment team. A few felt like they “had to do it” regardless of cost, and many were surprised by copays, missed work, and post-surgery medication costs. Some wished they had received estimates or been informed about financial resources and payment plans. Patients identified insurance companies as a source for cost information but received vague information regarding coverage. A few stated that while cost information would not have changed their treatment decision, it would have better prepared them for the financial impact.

Conclusions: Patients undergoing thyroidectomy are insufficiently informed of costs before surgery. Improved cost communication from treatment teams, hospitals, and insurance companies could help mitigate financial toxicity.

Presenting Author(s)

DK

Derek D. Kao, MD, MSCR

Resident
University of Michigan
Ypsilanti, MI, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

CJ

Catherine B. Jensen, MD

Resident
University of Michigan
Ann Arbor, MI, United States

Disclosure information not submitted.
EB

Elizabeth Bacon, MPH

University of Michigan, United States

Disclosure information not submitted.
SB

Sarah E. Bradley, PhD, MPH

Qualitative Analyst
University of Michigan
Asheville, NC, United States

Disclosure information not submitted.
JT

J. Denard Thomas, PhD

University of Michigan, United States

Disclosure information not submitted.

Senior Author(s)

SP

Susan C. Pitt, MD, MPHS

Associate Professor of Surgery
University of Michigan
Ann Arbor, MI, United States

Disclosure information not submitted.