Pizzo, E;
Ganesalingam, J;
Morris, S;
Sunderland, T;
Ames, D;
Labotesis, K;
(2015)
Cost-utility analysis of mechanical thrombectomy using stent retrievers in acute ischemic stroke.
Stroke
, 46
(9)
pp. 2591-2598.
10.1161/STROKEAHA.115.009396.
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Abstract
BACKGROUND AND PURPOSE: Recently, 5 randomized controlled trials demonstrated the benefit of endovascular therapy compared with intravenous tissue-type plasminogen activator in acute stroke. Economic evidence evaluating stent retrievers is limited. We compared the cost-effectiveness of intravenous tissue-type plasminogen activator alone versus mechanical thrombectomy and intravenous tissue-type plasminogen activator as a bridging therapy in eligible patients in the UK National Health Service. METHODS: A model-based cost-utility analysis was performed using a lifetime horizon. A Markov model was constructed and populated with probabilities, outcomes, and cost data from published sources, including 1-way and probabilistic sensitivity analysis. RESULTS: Mechanical thrombectomy was more expensive than intravenous tissue-type plasminogen activator, but it improved quality-adjusted life expectancy. The incremental cost per (quality-adjusted life year) gained of mechanical thrombectomy over a 20 year period was $11 651 (£7061). The probabilistic sensitivity analysis demonstrated that thrombectomy had a 100% probability of being cost-effective at the minimum willingness to pay for a quality-adjusted life year commonly used in United Kingdom. CONCLUSIONS: Although the upfront costs of thrombectomy are high, the potential quality-adjusted life year gains mean this intervention is cost-effective. This is an important factor for consideration in deciding whether to commission this intervention.
| Type: | Article |
|---|---|
| Title: | Cost-utility analysis of mechanical thrombectomy using stent retrievers in acute ischemic stroke |
| Location: | US |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1161/STROKEAHA.115.009396 |
| Publisher version: | http://dx.doi.org/10.1161/STROKEAHA.115.009396 |
| Language: | English |
| Additional information: | Stroke is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDervis License (https://creativecommons.org/licenses/by-nc-nd/3.0/), which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made. |
| Keywords: | cost-effectiveness; stents; stroke; thrombectomy; tissue-type plasminogen activator |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1470799 |
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