Stroke Care Costs and Cost-Effectiveness to Inform Health Policy

Bettger, Janet Prvu; Cadilhac, Dominique A.

doi:10.1161/strokeaha.122.037451

Cited by 9 publications

(4 citation statements)

References 22 publications

(24 reference statements)

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“…The results of our study highlight the necessity of re-organizing stroke care in Greece, with the full implementation of comprehensive continuous stroke services in order to achieve improved outcomes and thus increased value of care. Indeed, based on the results from a literature review conducted by the European Brain Council Value of Treatment, full implementation of comprehensive stroke services was related to an absolute decrease in risk of death or dependency (by 9.8%) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study

Siskou,

Galanis,

Konstantakopoulou

et al. 2023

Healthcare

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The aim of this study was to measure the one-year total cost of strokes and to investigate the value of stroke care, defined as cost per QALY. The study population included 892 patients with first-ever acute strokes, hemorrhagic strokes, and ischemic strokes, (ICD-10 codes: I61, I63, and I64) admitted within 48 h of symptoms onset to nine public hospitals located in six cities. We conducted a bottom-up cost analysis from the societal point of view. All cost components including direct medical costs, productivity losses due to morbidity and mortality, and informal care costs were considered. We used an annual time horizon, including all costs for 2021, irrespective of the time of disease onset. The average cost (direct and indirect) was extrapolated in order to estimate the national annual burden associated with stroke. We estimated the total cost of stroke in Greece at EUR 343.1 mil. a year in 2021, (EUR 10,722/patient or EUR 23,308 per QALY). Out of EUR 343.1 mil., 53.3% (EUR 182.9 mil.) consisted of direct healthcare costs, representing 1.1% of current health expenditure in 2021. Overall, productivity losses were calculated at EUR 160.2 mil. The mean productivity losses were estimated to be 116 work days with 55.1 days lost due to premature retirement and absenteeism from work, 18.5 days lost due to mortality, and 42.4 days lost due to informal caregiving by family members. This study highlights the burden of stroke and underlines the need for stakeholders and policymakers to re-organize stroke care and promote interventions that have been proven cost-effective.

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Section: Discussionmentioning

confidence: 99%

The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study

Siskou,

Galanis,

Konstantakopoulou

et al. 2023

Healthcare

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“…The United States has the highest average per-patient costs for stroke in the world, 92 but United States estimates of the cost of stroke vary dramatically, driven largely by differences in the populations studied and the cost-related methods utilized. 93,94 To date, the cost data available to GWTG-Stroke have been limited to Medicare fee-for-service claims, but as Medicare Advantage plans continue to expand, fee-forservice claims will represent an ever smaller proportion of admissions. Large representative hospital-based registries like GWTG-Stroke could provide data on hospital costs that could help fill the void of cost-of-care and cost-effectiveness studies in the United States.…”

Section: Collection Of Cost Datamentioning

confidence: 99%

Twenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges

Reeves,

Fonarow,

Smith

et al. 2024

Stroke

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The Get With The Guidelines-Stroke program which, began 20 years ago, is one of the largest and most important nationally representative disease registries in the United States. Its importance to the stroke community can be gauged by its sustained growth and widespread dissemination of findings that demonstrate sustained increases in both the quality of care and patient outcomes over time. The objectives of this narrative review are to provide a brief history of Get With The Guidelines-Stroke, summarize its major successes and impact, and highlight lessons learned. Looking to the next 20 years, we discuss potential challenges and opportunities for the program.

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“…The integration of economic evaluations into the decision-making process can help identify the most efficient use of limited healthcare resources and facilitate the adoption of new therapies that provide the greatest value to patients and society [21]. Given the significant human and economic impact of a stroke, the assessment of cost-effectiveness for emerging therapies is of particular importance to ensure that healthcare systems can provide optimal care while maintaining financial sustainability [22].…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Cerebrolysin after Ischemic Stroke: Secondary Analysis of the CARS Study

et al. 2023

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The cost-effectiveness of Cerebrolysin as an add-on therapy for moderate–severe acute ischemic stroke is a topic that remains understudied. This study aims to address this gap by performing a comprehensive cost-utility analysis using both deterministic and probabilistic methods from a payer perspective and within the Romanian inpatient care setting. Quality-adjusted life years (QALYs) were calculated using partial individual patient data from the 2016 Cerebrolysin and Recovery After Stroke (CARS) trial, utilizing three different health state valuation models. Cost data was extracted from actual acute care costs reported by Romanian public hospitals for reimbursement purposes for patients included in the CARS study. Incremental cost-effectiveness ratios were calculated for each treatment arm for the duration of the clinical trial. Deterministic analysis based on sample mean values indicates Cerebrolysin would be cost-effective at a threshold between roughly 18.8 and 29.9 thousand EUR, depending on valuation techniques. Probabilistic sensitivity analysis results indicate an 80% chance probability of cost-effectiveness of Cerebrolysin as an add-on therapy for acute ischemic stroke, considering a willingness-to-pay threshold of 50,000 EUR in a 90-day timeframe after stroke. Further economic evaluations of Cerebrolysin are needed to strengthen these findings, covering a timeframe of at least 12 months after the acute incident, which would account for treatment effects spanning beyond the first 90 days after ischemic stroke. These should be conducted to determine its cost-effectiveness under various care settings and patient pathways. Most importantly, modelling techniques are needed to answer important questions such as the estimates of population gain in QALYs after acute administration of Cerebrolysin and the potential offsetting of direct medical costs as a result of administering the intervention.

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Stroke Care Costs and Cost-Effectiveness to Inform Health Policy

Cited by 9 publications

References 22 publications

The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study

The Cost and the Value of Stroke Care in Greece: Results from the SUN4P Study

Twenty Years of Get With The Guidelines-Stroke: Celebrating Past Successes, Lessons Learned, and Future Challenges

Cost-Effectiveness of Cerebrolysin after Ischemic Stroke: Secondary Analysis of the CARS Study

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