国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Cost-effectiveness of endovascular therapy for acute ischemic stroke with large infarct in China

第一作者:Yuesong Pan

通讯作者:Zhongrong Miao

Intervention; Stroke; Thrombectomy.

基本信息

  • 负责人:Yuesong Pan
  • 数据来源: OTHERS
  • 论文编号:OTHERS20230114
  • 发表时间:2023-06-15

2023-06-15

已发表文章

发表杂志:J Neurointerv Surg

发表类型: Original Contributions

影响因子(IF): 4.8

PMID: 37328189 Pubmed原文链接 全文下载

主要研究背景及目的

Background: Endovascular therapy administered within 24 hours has been shown to improve outcomes for patients with acute ischemic stroke with large infarction, but the data on its cost-effectiveness are limited. Objective: To evaluate the cost-effectiveness of endovascular therapy for acute ischemic stroke with large infarction in China, the largest low- and middle-income country.

方法

Methods: A short-term decision tree model and a long-term Markov model were used to analyze the cost-effectiveness of endovascular therapy for patients with acute ischemic stroke with large infarction. Outcomes, transition probability, and cost data were obtained from a recent clinical trial and published literature. The benefit of endovascular therapy was assessed by the cost per quality-adjusted life-years (QALYs) gained in the short and long term. Deterministic one-way and probabilistic sensitivity analyses were performed to assess the robustness of the results.

结论

Conclusions: Endovascular therapy for acute ischemic stroke with large infarction could be cost-effective in China.

主要结果

Results: Compared with medical management alone, endovascular therapy for acute ischemic stroke with large infarction was found to be cost-effective from the fourth year onward and during a lifetime. In the long term, endovascular therapy yielded a lifetime gain of 1.33 QALYs at an additional cost of ¥73 900 (US$ 11 400), resulting in an incremental cost of ¥55 500 (US$ 8530) per QALY gained. Probabilistic sensitivity analysis showed that endovascular therapy was cost-effective in 99.5% of the simulation runs at a willingness-to-pay threshold of ¥243 000 (3 × gross domestic product per capita of China in 2021) per QALY gained.