Cost considerations in the pharmacological prevention and treatment of stroke.

Abstract:

:Stroke remains the leading cause of neurological disability and the third leading cause of death worldwide, consuming a large share of total healthcare expenditures. In this review, we discuss the cost effectiveness of stroke prevention for various risk factor-modification programmes and pharmacological interventions with aspirin (acetylsalicylic acid), ticlopidine and warfarin. Cost considerations and potential cost savings resulting from acute treatment are discussed for parenterally administered anticoagulants, such as heparin and nadroparin, and for intravenous thrombolysis with alteplase (recombinant tissue plasminogen activator; r-tPA). Patients with multiple risk factors for stroke require more aggressive prevention strategies which are associated with a greater risk of complications. The rates of complications, particularly intracerebral haemorrhage, should be kept low to achieve cost benefits for warfarin and alteplase. Reduced hospital length of stay is the key factor in the implementation of cost-effective stroke therapies. The analysis of future clinical trials of new stroke therapies should also include economic parameters, such as length of hospital stay and intensity of resource usage, to help guide formulary and therapeutic decision.

journal_name

Pharmacoeconomics

journal_title

PharmacoEconomics

authors

Alexandrov AV,Smurawska LT,Bartle W,Oh P

doi

10.2165/00019053-199711050-00004

subject

Has Abstract

pub_date

1997-05-01 00:00:00

pages

408-18

issue

5

eissn

1170-7690

issn

1179-2027

journal_volume

11

pub_type

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