OBJECTIVES: To assess the effectiveness and cost for secondary prevention of Chinese ischemic stroke patients who treated by Chinese traditional medicine Xuesaitong Soft Capsule (XSC) or Sanqi-Tongshu Capsule (STC).

METHODS: Data were obtained from electronic medical record database between Jan 1, 2010 and Dec 31, 2021 covering all general hospitals in Tianjin, China. Newly diagnosed ischemic stroke patients who were aged ≥ 18 years, treating with XSC or STC only, and patients treated combination or switched to another similar Chinese traditional medicine during observation were excluded. Short-term follow-up referred to patients were followed until occurrence of a cardiovascular event, 12 months after diagnosed ischemic stroke, and censoring, whichever came first. Long-term follow-up referred to patients were followed until occurrence of a cardiovascular event and censoring, whichever came first. Log-rank non-parametric test, Cox proportional hazards models, and rank sum tests adjusting for propensity score were used to examine the differences of recurrence rates and costs between groups using XSC and STC groups. Sensitivity analyses were conducted to test the robustness.

RESULTS: As for short-term follow-up period, there was no statistically significant difference in recurrence rates between XSC and STC group (5.6% vs. 9.2%, P=0.11), while XSC group had significant lower direct medical costs than STC group (27,667.55 CNY vs. 32,917.90 CNY P<0.001). As for long-term follow-up period, XSC group were associated with lower recurrence rates than STC group (14.3% vs. 27.9%, log-rank P<0.0001), and lower direct medical costs (47352.36 CNY vs. 54,482.30 CNY, P=0.005). The results were consistent in sensitivity analyses.

CONCLUSIONS: Compared with STC, XSC has comparable short-term clinical effectiveness but larger long-term effectiveness and lower direct medical costs.