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Quality of life and cost consequence of delays in endovascular treatment for acute ischemic stroke in China.
Ni, Weiyi; Kunz, Wolfgang G; Goyal, Mayank; Chen, Lijin; Jiang, Yawen.
Afiliação
  • Ni W; Department of Pharmaceutical and Health Economics, University of Southern California, Los Angeles, California, USA.
  • Kunz WG; Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
  • Goyal M; Departments of Radiology and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
  • Chen L; Chronic Disease Research Institute, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Jiang Y; School of Public Health (Shenzhen), Sun Yat-sen University, Room 215, Mingde Garden #6, Sun Yat-sen University, 132 East Outer Ring Road, Panyu District, Guangzhou, Guangdong, China. jiangyw26@mail.sysu.edu.cn.
Health Econ Rev ; 12(1): 4, 2022 Jan 06.
Article em En | MEDLINE | ID: mdl-34993675
ABSTRACT

BACKGROUND:

Although endovascular therapy (EVT) improves clinical outcomes in patients with acute ischemic stroke, the time of EVT initiation significantly influences clinical outcomes and healthcare costs. This study evaluated the impact of EVT treatment delay on cost-effectiveness in China.

METHODS:

A model combining a short-term decision tree and long-term Markov health state transition matrix was constructed. For each time window of symptom onset to EVT, the probability of receiving EVT or non-EVT treatment was varied, thereby varying clinical outcomes and healthcare costs. Clinical outcomes and cost data were derived from clinical trials and literature. Incremental cost-effectiveness ratio and incremental net monetary benefits were simulated. Deterministic and probabilistic sensitivity analyses were performed to assess the robustness of the model. The willingness-to-pay threshold per quality-adjusted life-year (QALY) was set to ¥71,000 ($10,281).

RESULTS:

EVT performed between 61 and 120 min after the stroke onset was most cost-effective comparing to other time windows to perform EVT among AIS patients in China, with an ICER of ¥16,409/QALY ($2376) for performing EVT at 61-120 min versus the time window of 301-360 min. Each hour delay in EVT resulted in an average loss of 0.45 QALYs and 165.02 healthy days, with an average net monetary loss of ¥15,105 ($2187).

CONCLUSIONS:

Earlier treatment of acute ischemic stroke patients with EVT in China increases lifetime QALYs and the economic value of care without any net increase in lifetime costs. Thus, healthcare policies should aim to improve efficiency of pre-hospital and in-hospital workflow processes to reduce the onset-to-puncture duration in China.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Health Econ Rev Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Health Econ Rev Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos
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