Cost-Effectiveness Analysis of Thrombolytic Treatment for Stroke

Mar, Javier; Begiristain, José María; Arrazola, Arantza

doi:10.1159/000087204

Cited by 61 publications

(70 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is much higher than reported in earlier studies. [2][3][4][5][6][7][8] The main explanation is the assumption of MRI imaging and a 24-hour medical service at the Department of Neurology and Department of Neuroradiology.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cost-Effectiveness of Intravenous Thrombolysis With Alteplase Within a 3-Hour Window After Acute Ischemic Stroke

Ehlers

Andersen

Clausen

et al. 2007

Stroke

View full text Add to dashboard Cite

Background and Purpose-The aim of this study was to assess the costs and cost-effectiveness of intravenous thrombolysis treatment with alteplase (Actilyse) of acute ischemic stroke with 24-hour in-house neurology coverage and use of magnetic resonance imaging. Methods-A health economic model was designed to calculate the marginal cost-effectiveness ratios for time spans of 1, 2, 3 and 30 years. Effect data were extracted from a meta-analysis of six large-scale randomized and placebo-controlled studies of thrombolytic therapy with alteplase. Cost data were extracted from thrombolysis treatment at Aarhus Hospital, Denmark, and from previously published literature. Results-The calculated cost-effectiveness ratio after the first year was $55 591 US per quality-adjusted life-year (base case). After the second year, computation of the cost-effectiveness ratio showed that thrombolysis was cost-effective. The long-term computations (30 years) showed that thrombolysis was a dominant strategy compared with conservative treatment given the model premises. Conclusions-A high-quality thrombolysis treatment with 24-hour in-house neurology coverage and magnetic resonance imaging might not be cost-effective in the short term compared with conservative treatment. In the long term, there are potentially large-scale health economic cost savings. (Stroke. 2007;38:85-89.)

show abstract

Section: Discussionmentioning

confidence: 99%

“…1 International health economic studies of intravenous thrombolysis treatment for acute ischemic stroke indicate that the intervention might be cost-effective in the short term and in the long term. [2][3][4][5][6][7][8][9] In all these studies patients, are assumed to receive the standard computed tomography-based approach to treatment.…”

mentioning

confidence: 99%

Cost-Effectiveness of Intravenous Thrombolysis With Alteplase Within a 3-Hour Window After Acute Ischemic Stroke

Ehlers

Andersen

Clausen

et al. 2007

Stroke

View full text Add to dashboard Cite

show abstract

“…Cost-effectiveness studies concerning primary 4 and secondary prevention 5 , diagnostic testing 6 , thrombolysis [7][8][9][10][11][12][13][14][15] , rehabilitation 16 , management systems 17 and also the informal care costs of long-term care after stroke 18,19 have been published. Few studies have explored the cost-effectiveness of mechanical thrombectomy [20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

The Cost of Materials for Intra-Arterial Thrombectomy

et al. 2013

View full text Add to dashboard Cite

This paper reports the cost of endovascular materials used for the treatment of large-vessel ischemic stroke in the anterior circulation according to the angiographic score and clinical results at three months. From November 2009 to July 2011, 57 ischemic patients (mean age, 64.6 ±13.8 years) with anterior large vessel occlusion were included. Mean National Institutes of Health Stroke Scale (NIHSS) on admission was 18.4 ± 4.9. Mean duration of symptoms until the arterial puncture was 207±67 minutes. Recanalization was assessed using the Thrombolysis In Myocardial Infarction (TIMI) score. Patient selection was performed on a non-enhanced CT scanner. According to the TIMI final angiographic score and the modified Rankin score (mRS) at three months, we determined the cost of the material used. Complete (n=12, TIMI grade 3) or partial perfusion (n=35, TIMI grade 2) was achieved in 47 (82.5%) lesions. At three months, 33.3% (n=19) had a mRS score ≤ 2. The mean cost of the material used in the operative room was 5018±2402 euro. Intra-arterial thrombolysis presents a substantial initial cost and the long-term economic impact has to be evaluated. Our health system has to take the price of these new technologies into account for future medical choices and urgently evaluate them in randomized controlled trials.

show abstract

“…Therefore, systemic intravenous thrombolysis has been established as a fi rst-line therapeutic strategy in patients admitted for stroke meeting specifi c criteria with cerebral hemorrhage being the main complication [1] . Since then, thrombolyis has proven to be cost-effective [2,3] , but only less than 4% of stroke patients currently benefi t from thrombolytic treatment [4] .…”

Section: Introductionmentioning

confidence: 99%