Cost-effectiveness of endovascular thrombectomy in patients with acute ischemic stroke.

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Aronsson, MattiasLinköpings universitet,Avdelningen för hälso- och sjukvårdsanalys,Medicinska fakulteten (author)

Cost-effectiveness of endovascular thrombectomy in patients with acute ischemic stroke.

Article/chapterEnglish2016

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American Academy of neurology,2016

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LIBRIS-ID:oai:gup.ub.gu.se/233686
https://gup.ub.gu.se/publication/233686URI
https://doi.org/10.1212/WNL.0000000000002439DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119063URI
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-126429URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:133180528URI

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Language:English

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Subject category:art swepub-publicationtype

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Funding agencies: Dental and Pharmaceutical Benefits Agency
Objective:To evaluate the cost-effectiveness of adding endovascular thrombectomy to standard care in patients with acute ischemic stroke.Methods:The cost-effectiveness analysis of endovascular thrombectomy in patients with acute ischemic stroke was based on a decision-analytic Markov model. Primary outcomes from ESCAPE, Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA), Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), Endovascular Revascularization With Solitaire Device Versus Best Medical Therapy in Anterior Circulation Stroke Within 8 Hours (REVASCAT), and Solitaire with the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke (SWIFT PRIME) along with data from published studies and registries were used in this analysis. We used a health care payer perspective and a lifelong time horizon to estimate costs and effects.Results:The model showed that adding thrombectomy with stent retrievers to guideline-based care (including IV thrombolysis) resulted in a gain of 0.40 life-years and 0.99 quality-adjusted life-years along with a cost savings of approximately $221 per patient. The sensitivity analysis showed that the results were not sensitive to changes in uncertain parameters or assumptions.Conclusions:Adding endovascular treatment to standard care resulted in substantial clinical benefits at low costs. The results were consistent throughout irrespective of whether data from ESCAPE, EXTEND-IA, MR CLEAN, REVASCAT, or SWIFT PRIME were used in this model.

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Persson, Josefine,1981Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation,Sahlgrenska Academy, University of Gothenburg(Swepub:gu)xpejos (author)
Blomstrand, Christian,1942Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation,Sahlgrenska Academy, University of Gothenburg(Swepub:gu)xbloch (author)
Wester, Per,1959-Karolinska Institutet,Umeå universitet,Medicin,Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Sweden,University of Umeå, Sweden; Danderyd Hospital Karolinska Institutet, Sweden, Sweden(Swepub:umu)pewe0002 (author)
Levin, Lars-Åke,1960Linköpings universitet,Avdelningen för hälso- och sjukvårdsanalys,Medicinska fakulteten(Swepub:liu)larle77 (author)
Linköpings universitetAvdelningen för hälso- och sjukvårdsanalys (creator_code:org_t)

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In:Neurology: American Academy of neurology86:11, s. 1053-90028-38781526-632X

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