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Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS

OBJECTIVE: To demonstrate, by a cost-effectiveness analysis, the efficiency of mechanical thrombectomy (MT) versus medical management (MM) in patients with a low Alberta Stroke Program Early CT Score (ASPECTS) from the RESCUE Study. METHODS: A cost-effectiveness model was designed to project both di...

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Autores principales: Moreu, Manuel, Scarica, Raffaele, Pérez-García, Carlos, Rosati, Santiago, López-Frías, Alfonso, Egido, José A, Gómez-Escalonilla, Carlos, Simal, Patricia, Arrazola, Juan, Bocquet, Anne-Laure, Barthe, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/
https://www.ncbi.nlm.nih.gov/pubmed/36564198
http://dx.doi.org/10.1136/jnis-2022-019849
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author Moreu, Manuel
Scarica, Raffaele
Pérez-García, Carlos
Rosati, Santiago
López-Frías, Alfonso
Egido, José A
Gómez-Escalonilla, Carlos
Simal, Patricia
Arrazola, Juan
Bocquet, Anne-Laure
Barthe, Thomas
author_facet Moreu, Manuel
Scarica, Raffaele
Pérez-García, Carlos
Rosati, Santiago
López-Frías, Alfonso
Egido, José A
Gómez-Escalonilla, Carlos
Simal, Patricia
Arrazola, Juan
Bocquet, Anne-Laure
Barthe, Thomas
author_sort Moreu, Manuel
collection PubMed
description OBJECTIVE: To demonstrate, by a cost-effectiveness analysis, the efficiency of mechanical thrombectomy (MT) versus medical management (MM) in patients with a low Alberta Stroke Program Early CT Score (ASPECTS) from the RESCUE Study. METHODS: A cost-effectiveness model was designed to project both direct medical costs and quality-adjusted life-years (QALYs) of MT versus MM in eight European countries (Spain, UK, France, Italy, Belgium, Germany, Sweden, and the Netherlands). Our model was created based on previously published health-economic data in those countries. Procedure costs, acute, mid-term, and long-term care costs were projected based on expected modified Rankin Scale (mRS) scores as reported in the RESCUE-Japan LIMIT trial. RESULTS: MT was found to be a cost-effective option in eight different countries across Europe (Spain, Italy, UK, France, Belgium, Germany, the Netherlands, and Sweden). with a lifetime incremental cost-effectiveness ratio varying from US$2 875 to US$11 202/QALY depending on the country. A cost-effectiveness acceptability curve showed 100% acceptability of MT at the willingness to pay (WTP) of US$40 000 for the eight countries. CONCLUSIONS: MT is efficient versus MM alone for patients with low ASPECTS in eight countries across Europe. Patients with a large ischemic core could be treated with MT because it is both clinically beneficial and economically sustainable.
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spelling pubmed-103139652023-07-02 Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS Moreu, Manuel Scarica, Raffaele Pérez-García, Carlos Rosati, Santiago López-Frías, Alfonso Egido, José A Gómez-Escalonilla, Carlos Simal, Patricia Arrazola, Juan Bocquet, Anne-Laure Barthe, Thomas J Neurointerv Surg Ischemic Stroke OBJECTIVE: To demonstrate, by a cost-effectiveness analysis, the efficiency of mechanical thrombectomy (MT) versus medical management (MM) in patients with a low Alberta Stroke Program Early CT Score (ASPECTS) from the RESCUE Study. METHODS: A cost-effectiveness model was designed to project both direct medical costs and quality-adjusted life-years (QALYs) of MT versus MM in eight European countries (Spain, UK, France, Italy, Belgium, Germany, Sweden, and the Netherlands). Our model was created based on previously published health-economic data in those countries. Procedure costs, acute, mid-term, and long-term care costs were projected based on expected modified Rankin Scale (mRS) scores as reported in the RESCUE-Japan LIMIT trial. RESULTS: MT was found to be a cost-effective option in eight different countries across Europe (Spain, Italy, UK, France, Belgium, Germany, the Netherlands, and Sweden). with a lifetime incremental cost-effectiveness ratio varying from US$2 875 to US$11 202/QALY depending on the country. A cost-effectiveness acceptability curve showed 100% acceptability of MT at the willingness to pay (WTP) of US$40 000 for the eight countries. CONCLUSIONS: MT is efficient versus MM alone for patients with low ASPECTS in eight countries across Europe. Patients with a large ischemic core could be treated with MT because it is both clinically beneficial and economically sustainable. BMJ Publishing Group 2023-07 2022-12-23 /pmc/articles/PMC10313965/ /pubmed/36564198 http://dx.doi.org/10.1136/jnis-2022-019849 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Ischemic Stroke
Moreu, Manuel
Scarica, Raffaele
Pérez-García, Carlos
Rosati, Santiago
López-Frías, Alfonso
Egido, José A
Gómez-Escalonilla, Carlos
Simal, Patricia
Arrazola, Juan
Bocquet, Anne-Laure
Barthe, Thomas
Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title_full Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title_fullStr Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title_full_unstemmed Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title_short Mechanical thrombectomy is cost-effective versus medical management alone around Europe in patients with low ASPECTS
title_sort mechanical thrombectomy is cost-effective versus medical management alone around europe in patients with low aspects
topic Ischemic Stroke
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10313965/
https://www.ncbi.nlm.nih.gov/pubmed/36564198
http://dx.doi.org/10.1136/jnis-2022-019849
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