Tuesday, December 3 | 3:50 p.m.-4:00 p.m. | T7-SSNPM02-6 | S402
During this session on noninterpretive skills, a study suggests that endovascular thrombectomy (EVT) is cost-effective in patients with basilar artery occlusion, from a U.S. healthcare perspective. The study comes on the heels of two recent studies showing the clinical benefit of the emerging procedure in patients up to 12 hours and between six and 24 hours from stroke onset.
Presenter Wolfgang Gerhard Kunz, MD, of Ludwig Maximilian University of Munich, Germany, and colleagues used clinical input data for both trials and built a decision model consisting of a short-run model to analyze costs and functional outcomes within 90 days after the index stroke and a long-run Markov state transition model (cycle length of 12 months) to estimate expected lifetime costs and outcomes from a healthcare and a societal perspective. They calculated incremental cost-effectiveness ratios (ICER) and analyzed deterministic (DSA) and probabilistic sensitivity (PSA).
According to the findings, EVT in addition to best medical management resulted in additional lifetime costs of $32,063 in the first trial and lifetime cost savings of $7690 in the second trial. From a healthcare perspective, EVT led to incremental costs and effectiveness of $37,389 and 2 quality-adjusted life years (QALYs) in the first trial as well as $3516 and 1.9 QALYs in the second trial, compared with best medical management alone.
The incremental cost-effectiveness ratio (ICER) values were $-4052/QALY in the first trial and $15,867/QALY in the second trial from a societal perspective. In each trial, PSA showed EVT to be cost-effective in most calculations (99.9%) for a willingness-to-pay threshold of $100,000/QALY. The cost of EVT and age at stroke represented the greatest impact on the ICER.
From an economic standpoint with a lifetime horizon, EVT in addition to best medical management is estimated to be highly effective and cost-effective in basilar artery occlusion stroke, the researchers conclude.
Finish off the day in this session on Tuesday afternoon to learn more.
