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
First author：Yuesong Pan
Corresponding author：Zhongrong Miao
essential_information
- Person in charge：Yuesong Pan
- Data Sources： OTHERS
- Number of papers：OTHERS20230114
- Published time：2023-06-15
2023-06-15
Published articles
Journal：J Neurointerv Surg
Publication type: Original Contributions
IF(IF): 4.8
PMID: 37328189 Link To Pubmed Full text Download
Background And Purpose
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.
Method
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.
Conclusion
Conclusions: Endovascular therapy for acute ischemic stroke with large infarction could be cost-effective in China.
Main results
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.