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Economic evaluation of human urinary kallindinogenase for patients with acute ischemic stroke in China.

Lin, Ziyi; Rao, Xiuqin; Zhang, Zhijun; Xuan, Jianwei.
J Med Econ; : 1-14, 2018 Apr 30.
Artigo em Inglês | | ID: mdl-29706099
OBJECTIVES: In China, both human urinary kallindinogenase (HUK) and 3-n-butylphthalide (NBP) were recommended for clinical use to improve cerebral blood circulation during an acute ischemic stroke (AIS). The objective was to evaluate the economic value of HUK versus NBP for patients with AIS from a Chinese payer's perspective. METHODS: An economic evaluation based on data of patients who have been treated with either HUK (N = 488) or NBP (N = 885) from a prospective, phase IV, multicenter, clinical registry study (Chinese Acute Ischemic Stroke Treatment Outcome Registry, CASTOR) was conducted to analyze the cost and effectiveness of HUK versus NBP for AIS in China. Before the analysis, the patients were matched using propensity score. Both a cost-minimization analysis and a cost-effectiveness analysis were conducted to compare the matched pairs. A bootstrapping exercise was conducted for the matched arms to demonstrate the probability of one intervention being cost-effective over another for a given willingness-to-pay for an extra quality-adjusted life-year (QALY). RESULTS: After propensity score matching, 463 pairs were matched. The overall medical cost in HUK arm is USD 2701.20, while the NBP arm is USD 3436.83, indicating HUK is preferred with cost-minimization analysis. Although the QALY gained in HUK arm (0.77176) compared with the NBP arm (0.76831) is statistically insignificant (p = 0.4862), our cost-effectiveness analysis as exploratory analysis found that, compared with NBP, HUK is a cost-saving strategy with the lower costs of USD 735.63 and greater QALYs gained of 0.00345. Among the 5000 bootstrapping replications, 100% indicates that HUK is cost-effective compared with NBP under a 1-time-GDP threshold; and 97.12% indicates the same under a 3-time-GDP threshold. CONCLUSION: This economic evaluation study indicates that administrating HUK is a cost-saving therapy compared with NBP for managing blood flow during AIS in Chinese setting.