急性缺血性卒中支架回收器选择的经济影响:美国、加拿大和欧洲八个国家医疗保健系统视角下mastero I的成本分析

IF 1.9 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Tommy Andersson, Hannes Nordmeyer, Waleed Brinjikji, Emilie Kottenmeier, Mina Kabiri, Shanti Scheffler, Patrick A Brouwer, Mahmood Mirza, Osama O Zaidat
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引用次数: 0

摘要

目的:根据mastero I活体系统评价和荟萃分析的结果,与使用Trevo®猎犬或Solitaire™血运重建器相比,使用EmboTrap®血运重建器治疗急性缺血性卒中(AIS)可获得更高的良好功能预后(90天修改Rankin量表[mRS] 0-2)。本分析的目的是评估三种常用支架回收器(SRs)在治疗AIS时实现功能改善的潜在经济影响。方法:从医疗保健系统的角度出发,建立了一个短期和长期成本的经济模型,使用决策树模拟1000名假设的AIS患者,使用EmboTrap、Trevo或Solitaire SRs进行机械取栓(MT)治疗。根据mastero I报告的每种器械90天mRS评分达到0-2或3-5的患者比例(不包括90天后无法存活的患者),该模型估计每位患者的成本和相关的增量成本节约。结果报告从医疗保健系统的角度来看,在美国,加拿大,英国,瑞典,德国,法国,意大利,西班牙,比利时和荷兰。结果:在所有10个国家中,在MT期间使用EmboTrap与最低的短期(从意大利的8412欧元到美国的66,525美元)、长期(从意大利的5249欧元到美国的25,757美元)和总(从意大利的13,661欧元到美国的92,282美元)相关。Trevo(意大利的14601欧元到美国的97487美元不等)和Solitaire(意大利的14840欧元到美国的98814美元不等)的每名患者总成本更高。在比较EmboTrap和Solitaire时,成本节约最高,其次是EmboTrap和Trevo, Trevo和Solitaire的成本节约最小。敏感性和情景分析的结果支持基本情况结果的稳健性。结论:在10个国家中,使用EmboTrap治疗AIS患者可以降低支付者的短期、长期和总成本。随着医疗成本的上升和医院预算的有限,这些结果表明,EmboTrap被证明是医院和医疗保健系统的循证经济SR选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The economic impact of stent retriever selection for acute ischemic stroke: a cost analysis of MASTRO I from the healthcare system perspective of the United States, Canada and eight European countries.

Aim: According to the results of the MASTRO I living systematic review and meta-analysis, use of the EmboTrap Revascularization® Device in the treatment of acute ischemic stroke (AIS) results in higher rates of good functional outcomes (90-day modified Rankin Scale [mRS] 0-2) compared with use of the Trevo® Retriever or the Solitaire™ Revascularization Device. The aim of this analysis was to assess the potential economic impact of achieving improved functional outcomes for three commonly used stent retrievers (SRs) in the treatment of AIS. Methods: An economic model with short-term and long-term costs, representing a healthcare system perspective was developed using a decision tree to simulate a cohort of 1000 hypothetical patients treated for AIS with mechanical thrombectomy (MT) using EmboTrap, Trevo or Solitaire SRs. Based on the proportion of patients who achieved a 90-day mRS score of 0-2 or 3-5 for each device reported in MASTRO I (excluding patients not surviving after 90 days), this model estimated per-patient costs and the associated incremental cost savings. Results are reported from the healthcare system perspective in the US, Canada, the UK, Sweden, Germany, France, Italy, Spain, Belgium and The Netherlands. Results: Across all ten countries, the use of EmboTrap during MT was associated with the lowest short-term (ranging from €8412 in Italy to $66,525 in the US), long-term (ranging from €5249 in Italy to $25,757 in the US) and total (ranging from €13,661 in Italy to $92,282 in the US) per-patient costs. The total per-patient cost was higher with Trevo (ranging from €14,601 in Italy to $97,487 in the US) and Solitaire (ranging from €14,840 in Italy to $98,814 in the US). Cost savings were highest when comparing EmboTrap versus Solitaire, followed by EmboTrap versus Trevo, with Trevo versus Solitaire having the smallest cost savings. Results of sensitivity and scenario analyses supported the robustness of the base-case results. Conclusion: Across the ten countries, treating patients with AIS with EmboTrap resulted in lower short-term, long-term and total costs to the payer. With rising healthcare costs and limited hospital budgets, these results suggest EmboTrap proves to be an evidence-based economical choice of SR for hospitals and healthcare systems.

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来源期刊
Journal of comparative effectiveness research
Journal of comparative effectiveness research HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.50
自引率
9.50%
发文量
121
期刊介绍: Journal of Comparative Effectiveness Research provides a rapid-publication platform for debate, and for the presentation of new findings and research methodologies. Through rigorous evaluation and comprehensive coverage, the Journal of Comparative Effectiveness Research provides stakeholders (including patients, clinicians, healthcare purchasers, and health policy makers) with the key data and opinions to make informed and specific decisions on clinical practice.
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