Medical Record Review to Characterize the Foundational Insights and Costs Associated with Intracerebral Hemorrhage (ICH) Management Among Ticagrelor-Treated Patients
Author(s)
John Fanikos, RPh, MBA1, Christina England, MPH2, Aishwarya Kulkarni, MS3, Vijay Abilash, MS3, Bhagyashree Oak, PhD3, Matthew O'Hara, MBA3, John McKenney, BASc2, Jackie Evans-Shields, PharmD2, Ralph J. Riello, III, PharmD4.
1North American Thrombosis Forum, Vasculearn Network, Brookline, MA, USA, 2SERB Pharmaceuticals, Conshohocken, PA, USA, 3Trinity Life Sciences, Waltham, MA, USA, 4Clinical & Translational Research Accelerator, Yale University School of Medicine, New Haven, CT, USA.
1North American Thrombosis Forum, Vasculearn Network, Brookline, MA, USA, 2SERB Pharmaceuticals, Conshohocken, PA, USA, 3Trinity Life Sciences, Waltham, MA, USA, 4Clinical & Translational Research Accelerator, Yale University School of Medicine, New Haven, CT, USA.
Presentation Documents
OBJECTIVES: Characterize key aspects of the patient journey, including clinical outcomes, healthcare resource utilization (HCRU), and cost of care among ticagrelor-treated patients hospitalized for management of ICH.
METHODS: We conducted an IRB-exempt, retrospective medical record review between November-December 2024. Neurologists/neurointensivists/neurosurgeons/trauma surgeons who annually manage ≥5 patients on ticagrelor undergoing ICH treatment completed an electronic questionnaire to abstract data on patient demographics, incidence of complications, pharmacy, blood product use, and HCRU. Descriptive analyses of survey results are reported for the phases of care: during and post-treatment. Costs were aggregated across multiple sources.
RESULTS: Nineteen physicians who responded to the online survey identified 69 ICH patients with 38% experiencing hematoma expansion and some with complications like seizures or brain swelling (35%) and mechanical ventilation (42%) during care. The average cost per patient associated with treatment was $24,793. Post treatment, common complications experienced were hemorrhagic complications (26%) and mechanical ventilation (33%). The average per patient cost associated with all complications post-procedure was calculated to be $23,849. 42% of patients were admitted to the intensive care unit (ICU) with an average length of stay (LOS) of 21.7 days in the Neuro-ICU or 11.1 days in the surgical ICU; 15% had non-ICU admissions, with an average LOS of 14.7 days. The average cost per patient associated with post-treatment hospital stay was calculated to be $18,208. Other expenditures associated with ICH treatment among patients receiving ticagrelor include costs for blood product and pharmacy utilization of $647 and $418 per patient, respectively.
CONCLUSIONS: Ticagrelor-treated patients hospitalized for ICH management require substantial HCRU due to frequent complications, prolonged hospital stays, and costly pharmacy and/or blood product use with uncertain clinical benefits. This study highlights the unmet need for more targeted treatment strategies to reduce the clinical and economic burden associated with ICH management related to ticagrelor use.
METHODS: We conducted an IRB-exempt, retrospective medical record review between November-December 2024. Neurologists/neurointensivists/neurosurgeons/trauma surgeons who annually manage ≥5 patients on ticagrelor undergoing ICH treatment completed an electronic questionnaire to abstract data on patient demographics, incidence of complications, pharmacy, blood product use, and HCRU. Descriptive analyses of survey results are reported for the phases of care: during and post-treatment. Costs were aggregated across multiple sources.
RESULTS: Nineteen physicians who responded to the online survey identified 69 ICH patients with 38% experiencing hematoma expansion and some with complications like seizures or brain swelling (35%) and mechanical ventilation (42%) during care. The average cost per patient associated with treatment was $24,793. Post treatment, common complications experienced were hemorrhagic complications (26%) and mechanical ventilation (33%). The average per patient cost associated with all complications post-procedure was calculated to be $23,849. 42% of patients were admitted to the intensive care unit (ICU) with an average length of stay (LOS) of 21.7 days in the Neuro-ICU or 11.1 days in the surgical ICU; 15% had non-ICU admissions, with an average LOS of 14.7 days. The average cost per patient associated with post-treatment hospital stay was calculated to be $18,208. Other expenditures associated with ICH treatment among patients receiving ticagrelor include costs for blood product and pharmacy utilization of $647 and $418 per patient, respectively.
CONCLUSIONS: Ticagrelor-treated patients hospitalized for ICH management require substantial HCRU due to frequent complications, prolonged hospital stays, and costly pharmacy and/or blood product use with uncertain clinical benefits. This study highlights the unmet need for more targeted treatment strategies to reduce the clinical and economic burden associated with ICH management related to ticagrelor use.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA59
Topic
Study Approaches
Disease
STA: Multiple/Other Specialized Treatments