Cost-effectiveness analysis of universal hypothyroidism screening in the general population aged 30–65 years in Spain

Key limitations include the use of constant transition probabilities and some inputs from international sources. Nonetheless, expert validation supports the model's relevance. The analysis adopts a conservative approach, excluding potential additional benefits like hyperthyroidism detection or integration with routine bloodwork, which could improve cost-effectiveness. Overall, hypothyroidism screening is a cost-effective strategy for the Spanish NHS, improving early detection, preventing progression, and enhancing quality of life in a frequently underdiagnosed population.