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KMID : 1130620100060030117
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Journal of Clinical Neurology
2010 Volume.6 No. 3 p.117 ~ p.126
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Cost-Effectiveness of Recombinant Tissue Plasminogen Activator in the Management of Acute Ischemic Stroke: A Systematic Review
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Jung Kee-Taig
Shin Dong-Wook
Lee Kyung-Jin
Oh Myung-Ju
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Abstract
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Background and Purpose: This work was undertaken to review the current cost-effectiveness analysis data on thrombolysis by intravenous (IV) therapy with recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke.
Methods: PubMed was searched for articles published between 1995 and 2008. The cost-effectiveness analysis data from eight eligible studies were reviewed, paying particular attention to their modeling assumptions and the quality of the source data.
Results: The reviewed studies were from six countries: USA (n=2), UK (n=2), Canada (n=1), Australia (n=1), Spain (n=1), and Denmark (n=1); most were performed from the healthcare-system and/or societal perspectives. IV rtPA was associated with an acceptable increase in short-term cost [range: US$ 36-236/patient; US$ 29,148-55,591/quality-adjusted life-years (QALYs)], and a net long-term cost saving that was higher from a societal perspective (range: -US$ 12,043 to -US$ 630/patient; -US$ 207,253 to -US$ 21,938/QALYs) than from a healthcare-system perspective (range: -US$ 5,811 to -US$ 5,415/patient; -US$ 41,137 to -US$ 4,662/QALYs).
Conclusions: IV rtPA seems to be a cost-effective strategy for the management of acute ischemic stroke, and might reduce the associated healthcare costs as well as patients’ disabilities. Further cost-effectiveness research and the development of a public health strategy are warranted to optimize the use of rtPA in Korea.
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KEYWORD
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thrombolysis, stroke, recombinant tissue plasminogen activator, cost-effectiveness analysis
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