Cost-Effectiveness of Treatments for Acute Ischemic Stroke
Summary
Acute ischaemic stroke places a substantial burden on health systems worldwide, prompting rigorous evaluation of therapies not only for clinical efficacy but also for economic value. Intravenous thrombolysis with tissue plasminogen activator remains a cornerstone within a narrow therapeutic window, yielding favourable cost–utility profiles in high-income and emerging settings. Endovascular thrombectomy has revolutionised care for large vessel occlusion, demonstrating superior functional outcomes and survival benefits; economic analyses capture these gains as quality-adjusted life-years (QALYs) against increased procedural expenses. Imaging selection, particularly via computed tomography perfusion, refines patient eligibility and can enhance net monetary benefit by focusing resources on those most likely to improve. Time to treatment emerges as a critical determinant of both health and economic returns; delays translate directly into lost QALYs and rising long-term costs. Health economic models, often employing Markov processes and decision trees, integrate short- and long-term data to derive incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMBs), guiding policy on service configuration, transfer protocols and investment in specialised centres. Overall, the global evidence underscores that prompt, appropriately selected reperfusion therapies provide substantial health gains at justifiable costs, supporting expanded access to advanced imaging and intervention strategies.
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Cost-Effectiveness of Treatments for Acute Ischemic Stroke publication trend
The graph below shows the total number of articles in cost-effectiveness of treatments for acute ischemic stroke across all publications each year (not limited to Nature Index journals).
Technical terms
Quality-adjusted life-year (QALY): A measure combining life expectancy and health-related quality of life into a single metric.
Incremental cost-effectiveness ratio (ICER): The additional cost per additional unit of health gain (typically per QALY) when comparing two interventions.
Net monetary benefit (NMB): A calculation converting health gains into monetary terms and subtracting costs to determine overall economic value.
Markov model: A mathematical framework that simulates transitions between health states over time to estimate long-term costs and outcomes.
Endovascular thrombectomy: A mechanical procedure to remove cerebral arterial clots via catheter, typically for large vessel occlusions.
Computed tomography perfusion (CTP): An imaging technique that assesses cerebral blood flow and viability to guide treatment decisions.
References
- Cost-effectiveness of CT perfusion for the detection of large vessel occlusion acute ischemic stroke followed by endovascular treatment: a model-based health economic evaluation study. European Radiology (2023).
- Quantified health and cost effects of faster endovascular treatment for large vessel ischemic stroke patients in the Netherlands. Journal of NeuroInterventional Surgery (2021).
- Quality of life and cost consequence of delays in endovascular treatment for acute ischemic stroke in China. Health Economics Review (2022).
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