Cost-Effectiveness of Ginkgo Diterpene Lactone Meglumine Injection for Patients With Acute Ischemic Stroke in China

Speaker(s)

Zha J1, Li M2, Hu Z1, Lu KZ3, Zhao J4, Yuan J1
1Fudan University, Shanghai, 31, China, 2University of Tennessee Health Science Center, Memphis, TN, USA, 3University of South Carolina, Columbia, SC, USA, 4Fudan University, Shanghai, Shanghai, China

Presentation Documents

OBJECTIVES: Ginkgo diterpene lactone meglumine (GDLM), made of extracts from ginkgo biloba L., has been widely used as an adjuvant therapy for treating acute ischemic stroke (AIS) in China. However, the data on its cost-effectiveness is scarce. Hence, this study aimed to evaluate the cost-effectiveness of GDLM injection versus placebo among AIS patients in China from a healthcare system perspective.

METHODS: The decision tree and Markov model were developed to simulate cost-effectiveness of GDLM injection versus placebo over lifetime. The modified Rankin scale score (mRS) at 90 days, which was derived from a randomized control trial (NCT02526225), was used to define health states. Transition probabilities and healthcare costs were obtained from the China National Stroke Registry. An annual discount rate of 5% was applied. Sensitivity analyses were performed to test the robustness of the results. Threshold analysis assumed a willingness-to-pay (WTP) value of 89,358 CNY/QALY gained.

RESULTS: In the base case, the GDLM injection provided 5.08 quality-adjusted life years (QALYs) compared to 4.96 QALYs in the placebo group, with 0.12 QALYs gained across 30-year time horizon. The mean costs in the GDLM group were 174,227.47 CNY compared with 174,788.45 CNY for placebo. The ICER was negative at -4638.39 CNY/QALY. Therefore, the GDLM injection dominated placebo. One-way sensitivity analysis revealed ICER being lower than the WTP threshold. The parameters with the greatest influence on the ICER were time horizon, post-hospitalization costs, relative risk of functional independence. Probabilistic sensitivity analysis results demonstrated that the GDLM injection is cost-effective relative to placebo ranged from 61.3% to 100%, suggesting that the results were generally robust.

CONCLUSIONS: The GDLM injection was associated with markedly gains in quality-adjusted life expectancy and decreased healthcare costs. GDLM adjuvant therapy is a cost-effective choice for AIS patients in China.

Code

EE254

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory)