Preliminary Budget IMPACT Analysis of Advanced Imaging and Mechanical Thrombectomy for ACUTE Ischaemic Stroke Beyond 6 Hours from Onset in the United Kingdom
Author(s)
Peultier AC, Redekop K, Severens JLH
Erasmus University Rotterdam, Rotterdam, Netherlands
OBJECTIVES : Mechanical thrombectomy (MT) informed by advanced imaging (ADIM) is cost-effective up to 24 hours from acute ischaemic stroke (AIS) onset in the United Kingdom (UK). Our goal is to assess the financial impact of commissioning ADIM and MT within and beyond 6 hours from onset in the UK (compared to conventional imaging and MT within 6 hours only). METHODS : We used the decision tree and Markov trace of a recently published cost-effectiveness analysis. We considered 87,078 as the average annual number of AIS patients admitted to the hospital. All suspected stroke patients were considered to be diagnosed by ADIM which was modelled with a perfect accuracy. Given the lack of evidence regarding the prior probability for an AIS patient to benefit from late MT, 3 scenarios were simulated. The UK NHS perspective was used and costs were based on the year 2018. Acute care costs and post-stroke costs indexed on the level of dependence were included. RESULTS : Assuming prior probabilities of 10%, 20% and 30%, the annual number of MTs performed beyond 6 hours would be 6,382, 12,765 and 19,147, respectively. At a 3-year time horizon, preliminary analyses show that the financial impact of ADIM + MT beyond 6 hours (versus conventional care within 6 hours) would be £113,320,807 (+3%), £200,898,224 (+5%) and £288,475,021 (+7%), respectively. Considering an annual NHS budget for new stroke cases of £1.6 billion, this would suggest an annual budget increase of 2.4%, 4.2% and 6%, respectively. CONCLUSIONS : A more precise estimate of the prior probability to benefit from late MT is needed to ascertain our preliminary results. Although ADIM and MT up to 24 hours from onset is cost-effective, it is important to assess whether the NHS can afford this intervention for all eligible patients and widespread ADIM for all suspected stroke patients countrywide.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PCV60
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis, Diagnostics & Imaging, Medical Devices
Disease
Cardiovascular Disorders