HEALTHCARE RESOURCE UTILIZATION AND COSTS OF RECURRENT STROKES IN MEDICARE FEE-FOR-SERVICE BENEFICIARIES IN THE UNITED STATES
Author(s)
Emily Durden, PhD1, Jinlin Song, PhD2, Manasvi Sundar, MPH2, Lawrence Fried, MBA, MD1, Jean Lee, PharmD, MS1, Keith A. Betts, PhD2.
1Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA, 2Analysis Group, Inc., Los Angeles, CA, USA.
1Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA, 2Analysis Group, Inc., Los Angeles, CA, USA.
OBJECTIVES: To assess healthcare resource utilization (HCRU) and costs associated with recurrent ischemic strokes among Medicare beneficiaries with primary non-cardioembolic ischemic stroke (NCIS) or transient ischemic attack (TIA).
METHODS: Adults ≥65 years of age who had an inpatient or emergency room visit with a primary diagnosis of NCIS or TIA, and no prior history of stroke, were identified using Medicare fee-for-service data from January 2007 to September 2024. Patients were followed from the index NCIS or TIA event until disenrollment, death, or the end of data availability. Costs of the index NCIS or TIA and each recurrent ischemic stroke were assessed during the events and for the period during and up to 1 year after each stroke or TIA event.
RESULTS: Overall, 1,291,897 patients with NCIS/TIA were identified (mean ± standard deviation [SD] age 77.8 ± 8.0 years; 56.3% females). At index, 62.0% of patients had NCIS and 38.0% had TIA. The mean (SD) cost for the index NCIS or TIA was $9,366 ($13,578) and $13,318 ($16,348) for the second stroke, $13,695 ($16,460) for the third, $13,609 ($14,947) for the fourth, and $14,180 ($16,740) for the fifth. The mean (SD) all-cause medical costs (per patient per month) during and up to 1 year after the stroke event increased with each recurrence: index NCIS or TIA: $6,044 ($10,360); second stroke: $9,937 ($12,859); third: $11,140 ($13,064); fourth: $12,001 ($13,624); fifth: $12,754 ($13,976). Utilization of skilled nursing facilities also increased with each recurrent stroke: index NCIS or TIA: 22.6%; second stroke: 36.2%; third: 40.8%; fourth: 42.2%; fifth: 44.7%.
CONCLUSIONS: Recurrent ischemic strokes impose substantial economic burden. The progressive increase in costs and post-acute care utilization with each recurrent event underscore the need for effective secondary stroke prevention strategies.
METHODS: Adults ≥65 years of age who had an inpatient or emergency room visit with a primary diagnosis of NCIS or TIA, and no prior history of stroke, were identified using Medicare fee-for-service data from January 2007 to September 2024. Patients were followed from the index NCIS or TIA event until disenrollment, death, or the end of data availability. Costs of the index NCIS or TIA and each recurrent ischemic stroke were assessed during the events and for the period during and up to 1 year after each stroke or TIA event.
RESULTS: Overall, 1,291,897 patients with NCIS/TIA were identified (mean ± standard deviation [SD] age 77.8 ± 8.0 years; 56.3% females). At index, 62.0% of patients had NCIS and 38.0% had TIA. The mean (SD) cost for the index NCIS or TIA was $9,366 ($13,578) and $13,318 ($16,348) for the second stroke, $13,695 ($16,460) for the third, $13,609 ($14,947) for the fourth, and $14,180 ($16,740) for the fifth. The mean (SD) all-cause medical costs (per patient per month) during and up to 1 year after the stroke event increased with each recurrence: index NCIS or TIA: $6,044 ($10,360); second stroke: $9,937 ($12,859); third: $11,140 ($13,064); fourth: $12,001 ($13,624); fifth: $12,754 ($13,976). Utilization of skilled nursing facilities also increased with each recurrent stroke: index NCIS or TIA: 22.6%; second stroke: 36.2%; third: 40.8%; fourth: 42.2%; fifth: 44.7%.
CONCLUSIONS: Recurrent ischemic strokes impose substantial economic burden. The progressive increase in costs and post-acute care utilization with each recurrent event underscore the need for effective secondary stroke prevention strategies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE424
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis, Cost/Cost of Illness/Resource Use Studies, Value of Information
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)