Background and Purpose:Mechanical thrombectomy (MT) has been recommended for the treatment of nonminor ischemic stroke by national and international guidelines, but cost-effectiveness evidence has been generated for only a few countries using heterogeneous evaluation methods. We estimate the cost-effectiveness of MT across 32 European countries.Methods:A Markov model was developed to estimate the cost-effectiveness of MT compared with standard care over a 5-year time horizon. Patients with ischemic stroke eligible for MT were identified from 2017 country-specific incidence data. A societal perspective was adopted, including health, social, and informal care costs, and productivity losses. Model outcomes were expressed as quality-adjusted life years. Sensitivity analyses were conducted to test the robustness of findings.Results:We identified 267 514 ischemic stroke cases that were eligible for MT treatment across 32 European countries. MT was found to be more effective and cheaper than standard care in two-thirds of the countries (21/32) and cost-effective in all but one country (Bulgaria). Across Europe, the intervention was estimated to produce over 101 327 additional quality-adjusted life years (95% uncertainty interval, 65 180-149 085) and cost savings of $981 million (euro868 million, 95% uncertainty interval, -1544 to 2564) and of $1.7 billion (euro1.5 billion, 95% uncertainty interval, -1.2 to 3.6) in health and social care and societal costs, respectively.Conclusions:MT is highly likely to be cost-effective compared with standard care across Europe as a whole and in the vast majority of European countries.
Cost-Effectiveness of Mechanical Thrombectomy for Treatment of Nonminor Ischemic Stroke Across Europe / Candio, Paolo; Violato, Mara; Leal, Jose; Luengo-Fernandez, Ramon. - In: STROKE. - ISSN 0039-2499. - 52:2(2021), pp. 664-673. [10.1161/strokeaha.120.031027]
Cost-Effectiveness of Mechanical Thrombectomy for Treatment of Nonminor Ischemic Stroke Across Europe
Candio, Paolo
Primo
;
2021-01-01
Abstract
Background and Purpose:Mechanical thrombectomy (MT) has been recommended for the treatment of nonminor ischemic stroke by national and international guidelines, but cost-effectiveness evidence has been generated for only a few countries using heterogeneous evaluation methods. We estimate the cost-effectiveness of MT across 32 European countries.Methods:A Markov model was developed to estimate the cost-effectiveness of MT compared with standard care over a 5-year time horizon. Patients with ischemic stroke eligible for MT were identified from 2017 country-specific incidence data. A societal perspective was adopted, including health, social, and informal care costs, and productivity losses. Model outcomes were expressed as quality-adjusted life years. Sensitivity analyses were conducted to test the robustness of findings.Results:We identified 267 514 ischemic stroke cases that were eligible for MT treatment across 32 European countries. MT was found to be more effective and cheaper than standard care in two-thirds of the countries (21/32) and cost-effective in all but one country (Bulgaria). Across Europe, the intervention was estimated to produce over 101 327 additional quality-adjusted life years (95% uncertainty interval, 65 180-149 085) and cost savings of $981 million (euro868 million, 95% uncertainty interval, -1544 to 2564) and of $1.7 billion (euro1.5 billion, 95% uncertainty interval, -1.2 to 3.6) in health and social care and societal costs, respectively.Conclusions:MT is highly likely to be cost-effective compared with standard care across Europe as a whole and in the vast majority of European countries.File | Dimensione | Formato | |
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