Modeling the Cost Effectiveness of Neuroimaging-Based Treatment of Acute Wake-Up Stroke

Ankur Pandya, Ashley A Eggman, Hooman Kamel, Ajay Gupta, Bruce R Schackman and Pina C Sanelli

PLOS ONE, 2016, vol. 11, issue 2, 1-13

Abstract: Background: Thrombolytic treatment (tissue-type plasminogen activator [tPA]) is only recommended for acute ischemic stroke patients with stroke onset time 4.5 hours, 46.3% experienced a good stroke outcome. Lifetime discounted QALYs and costs were 5.312 and $88,247 for the no treatment strategy and 5.342 and $90,869 for the MRI-based strategy, resulting in an ICER of $88,000/QALY. Results were sensitive to variations in patient- and provider-specific factors such as sleep duration, hospital travel and door-to-needle times, as well as onset probability distribution, MRI specificity, and mRS utility values. Conclusions: Our model-based findings suggest that an MRI-based treatment strategy for this population could be cost-effective and quantifies the impact that patient- and provider-specific factors, such as sleep duration, hospital travel and door-to-needle times, could have on the optimal decision for wake-up stroke patients.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0148106

DOI: 10.1371/journal.pone.0148106

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