Burden of stroke in Italy: An economic model highlights savings arising from reduced disability following thrombolysis

作者：Chiumente M^*; Gianino M M; Minniti D; Mattei T J; Spass B; Kamal K M; Zimmerman D E; Muca A; Luda E

来源：International Journal of Stroke, 2015, 10(6): 849-855.

DOI：10.1111/ijs.12481

• cost
• disability
• Italy
• stroke
• thrombolysis
• tPA

BackgroundThe consequences of stroke must be assessed not only in terms of incidence and mortality rates, but also in terms of disability, which may persist long after the acute phase. Thrombolysis, if timely administered, can effectively reduce post-stroke disability.
AimsThe economic model presented herein aims to evaluate, in eligible patients, the effects of alteplase on post-stroke disability and related costs over three-years.
MethodsThe economic analysis was developed on the basis of four key components: clinical outcomes from international trials, economic consequences extracted from cost of illness studies, regulatory data from national and international agencies, and national epidemiological data. A population-level model estimated the difference in disability costs between patients treated with standard care versus those receiving thrombolytic therapy within 4x5h of acute ischemic stroke. The analysis covered 36 months from discharge.
ResultsReduced costs related to post-stroke disability were observed in treated patients compared with those receiving standard care (control). The overall savings were Euro2330x15 per average patient: Euro1445x81 during the first 18 months, Euro362x25 between 18 and 24 months, and Euro522x09 in the 24-36 months period. The overall savings on 3174 Italian treated patients in 2013 were Euro7395907 over three-years.
ConclusionOur study reveals that performing thrombolytic therapy in eligible patients improves economic outcomes compared with patients receiving standard care. This model is useful for decision makers, both within and outside of the Italian national context, as a tool to assess the cost-effectiveness of thrombolysis in both short- and long-term period.

• 出版日期2015-8