Analysis of Swedish Stroke Registry Demonstrates Long-Term Cost Effectiveness of Thrombectomy

April 19, 2017—Katarina Steen Carlsson, PhD, et al conducted an investigation of the long-term cost effectiveness of thrombectomy after thrombolysis versus thrombolysis alone using real-world outcome data on the need for health care, home help, and nursing home care. Findings from the analysis, which is based on data from the Swedish Stroke Register, were recently published online ahead of print in International Journal of Stroke.

The investigators concluded that although thrombectomy has a small effect on hospital costs (except for the direct intervention cost), it is highly likely to lead to substantial cost savings in the social service sector, up to four times the increase in health care costs.

As summarized in International Journal of Stroke, the investigators analyzed real-life resource use and survival data from the Swedish Stroke Register and pooled outcomes from five randomized controlled trials published in 2015 in a newly constructed Markov cost-effectiveness model with a societal perspective.

Data were stratified by age (18–64, 65–74, and 75–84 years) and modified Rankin scale at 3 months for patients with an index ischemic stroke in 2014 that fulfilled inclusion criteria (National Institutes of Health Stroke Scale score ≥  8) before treatment and were treated with thrombolysis (n = 710). Univariate sensitivity analyses explored the robustness of the results. A lifetime perspective and 3% discount rate were applied.

The investigators found that thrombectomy increases the health care cost per patient (+£9000), mainly because of intervention costs, but the reduced burden on the social services (home help services −£13,000; nursing home care −£26,000) implies overall cost savings. The average patient gain was 1 quality-adjusted life-year with higher gains for younger age groups, reported the investigators in International Journal of Stroke.