*Review* **Differentiated Thyroid Cancer: A Health Economic Review**

**Klaas Van Den Heede 1,2,\*, Neil S. Tolley 1,3, Aimee N. Di Marco 1,3 and Fausto F. Palazzo 1,3**

<sup>1</sup> Department of Endocrine & Thyroid Surgery, Hammersmith Hospital, London W12 0HS, UK;

n.tolley@imperial.ac.uk (N.S.T.); a.di-marco@imperial.ac.uk (A.N.D.M.); f.palazzo@imperial.ac.uk (F.F.P.)


**\*** Correspondence: klaas.vandenheede@nhs.net

**Simple Summary:** This review reflects on health economic considerations associated with the increasing diagnosis and treatment of differentiated thyroid cancer. Analysis of different relevant health economic topics, such as overdiagnosis, overtreatment, surgical costs, and costs of followup are being addressed. Several unanswered research questions such as optimising molecular markers for diagnosis, active surveillance of primary tumours, and improved risk stratification and survivorship care all influence future healthcare expenditures.

**Abstract:** The incidence of differentiated thyroid cancer (DTC) is rising, mainly because of an increased detection of asymptomatic thyroid nodularity revealed by the liberal use of thyroid ultrasound. This review aims to reflect on the health economic considerations associated with the increasing diagnosis and treatment of DTC. Overdiagnosis and the resulting overtreatment have led to more surgical procedures, increasing health care and patients' costs, and a large pool of community-dwelling thyroid cancer follow-up patients. Additionally, the cost of thyroid surgery seems to increase year on year even when inflation is taken into account. The increased healthcare costs and spending have placed significant pressure to identify potential factors associated with these increased costs. Some truly ground-breaking work in health economics has been undertaken, but more cost-effectiveness studies and micro-cost analyses are required to evaluate expenses and guide future solutions.

**Keywords:** cost-benefit analysis; economics; medical; thyroid neoplasms
