Abstract:
BACKGROUND AND PURPOSE:The aim of this study was to assess the costs and cost-effectiveness of intravenous thrombolysis treatment with alteplase (Actilyse) of acute ischemic stroke with 24-hour in-house neurology coverage and use of magnetic resonance imaging. METHODS:A health economic model was designed to calculate the marginal cost-effectiveness ratios for time spans of 1, 2, 3 and 30 years. Effect data were extracted from a meta-analysis of six large-scale randomized and placebo-controlled studies of thrombolytic therapy with alteplase. Cost data were extracted from thrombolysis treatment at Aarhus Hospital, Denmark, and from previously published literature. RESULTS:The calculated cost-effectiveness ratio after the first year was $55,591 US per quality-adjusted life-year (base case). After the second year, computation of the cost-effectiveness ratio showed that thrombolysis was cost-effective. The long-term computations (30 years) showed that thrombolysis was a dominant strategy compared with conservative treatment given the model premises. CONCLUSIONS:A high-quality thrombolysis treatment with 24-hour in-house neurology coverage and magnetic resonance imaging might not be cost-effective in the short term compared with conservative treatment. In the long term, there are potentially large-scale health economic cost savings.
journal_name
Strokejournal_title
Strokeauthors
Ehlers L,Andersen G,Clausen LB,Bech M,Kjølby Mdoi
10.1161/01.STR.0000251790.19419.a8subject
Has Abstractpub_date
2007-01-01 00:00:00pages
85-9issue
1eissn
0039-2499issn
1524-4628pii
01.STR.0000251790.19419.a8journal_volume
38pub_type
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