Photo credit: stockdevilStroke – a blood clot or bleeding in the brain – is one of the primary causes of handicaps and premature death, but also means a great burden on family members and high costs to society.
Last year, five positive studies into the effects of thrombectomy – a treatment in which an instrument is pushed up into the affected blood vessel in the brain, and then the blood clot is removed via suction or a metal mesh – were published.
One question that remains is whether the benefit of thrombectomy in the event of serious stroke can justify the costs of the treatment. In a study, now being published in the American periodical Neurology and carried out by researchers at the Linköping University Division of Healthcare Analysis and colleagues at Gothenburg University and Karolinska Institutet, the cost per quality-adjusted year of survival was calculated for thrombectomy in stroke patients.
The analysis used a simulation model in which the effects of the treatment on quality of life, lifespan, and costs were calculated based on the clinical studies from 2015. The results of this calculation were then compared with an alternative in which the patient was treated without thrombectomy. The analysis showed that thrombectomy in the event of serious stroke entailed major gains in quality of life, but also that the high initial costs for the procedure were compensated for over time by savings in the form of reduced need for care.
Thrombectomy thus provides improved quality of life to gravely ill patients without appreciably affecting long-term costs for society.
The results give hope, and will likely affect future stroke care in Sweden.
Cost-effectiveness of endovascular thrombectomy in patients with acute ischemic stroke by Mattias Aronsson, Josefine Persson, Christian Blomstrand, Per Wester and Lars-Åke Levin. Neurology online before print 12 February 2016. doi:http://dx.doi.org/10.1212/ WNL.0000000000002439
Åke Hjelm 24 Feb 2016