Cost-Effectiveness of Recombinant Tissue Plasminogen Activator in the Management of Acute Ischemic Stroke: A Systematic Review.
- Author:
Kee Taig JUNG
1
;
Dong Wook SHIN
;
Kyung Jin LEE
;
Myungju OH
Author Information
- Publication Type:Review
- Keywords: thrombolysis; stroke; recombinant tissue plasminogen activator; cost-effectiveness analysis
- MeSH: Australia; Canada; Cost Savings; Denmark; Health Care Costs; Korea; Public Health; Spain; Stroke; Tissue Plasminogen Activator
- From:Journal of Clinical Neurology 2010;6(3):117-126
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND PURPOSE: This work was undertaken to review the current cost-effectiveness analysis data on thrombolysis by intravenous (IV) therapy with recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke. METHODS: PubMed was searched for articles published between 1995 and 2008. The cost-effectiveness analysis data from eight eligible studies were reviewed, paying particular attention to their modeling assumptions and the quality of the source data. RESULTS: The reviewed studies were from six countries: USA (n=2), UK (n=2), Canada (n=1), Australia (n=1), Spain (n=1), and Denmark (n=1); most were performed from the healthcare-system and/or societal perspectives. IV rtPA was associated with an acceptable increase in short-term cost [range: US$ 36-236/patient; US$ 29,148-55,591/quality-adjusted life-years (QALYs)], and a net long-term cost saving that was higher from a societal perspective (range: -US$ 12,043 to -US$ 630/patient; -US$ 207,253 to -US$ 21,938/QALYs) than from a healthcare-system perspective (range: -US$ 5,811 to -US$ 5,415/patient; -US$ 41,137 to -US$ 4,662/QALYs). CONCLUSIONS: IV rtPA seems to be a cost-effective strategy for the management of acute ischemic stroke, and might reduce the associated healthcare costs as well as patients' disabilities. Further cost-effectiveness research and the development of a public health strategy are warranted to optimize the use of rtPA in Korea.
