Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Wolfgang G. Kunz - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Peter B. Sporns - , Universität Basel, Universität Hamburg (Autor:in)
  • Marios N. Psychogios - , Universität Basel (Autor:in)
  • Jens Fiehler - , Universität Hamburg (Autor:in)
  • René Chapot - , Alfried Krupp Krankenhaus (Autor:in)
  • Franziska Dorn - , Universität Bonn (Autor:in)
  • Astrid Grams - , Medizinische Universität Innsbruck (Autor:in)
  • Andrea Morotti - , University of Brescia (Autor:in)
  • Patricia Musolino - , Harvard University (Autor:in)
  • Sarah Lee - , Stanford University (Autor:in)
  • André Kemmling - , Philipps-Universität Marburg (Autor:in)
  • Hans Henkes - , Klinikum Stuttgart (Autor:in)
  • Omid Nikoubashman - , Universitätsklinikum Aachen (Autor:in)
  • Martin Wiesmann - , Universitätsklinikum Aachen (Autor:in)
  • Ulf Jensen-Kondering - , Christian-Albrechts-Universität zu Kiel (CAU) (Autor:in)
  • Markus Möhlenbruch - , Universität Heidelberg (Autor:in)
  • Marc Schlamann - , Universität zu Köln (Autor:in)
  • Wolfgang Marik - , Medizinische Universität Wien (Autor:in)
  • Stefan Schob - , Universität Leipzig (Autor:in)
  • Christina Wendl - , Universität Regensburg (Autor:in)
  • Bernd Turowski - , Heinrich Heine Universität Düsseldorf (Autor:in)
  • Friedrich Götz - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Daniel Kaiser - , Institut und Poliklinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität Dresden (Autor:in)
  • Konstantinos Dimitriadis - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Alexandra Gersing - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Thomas Liebig - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Jens Ricke - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Paul Reidler - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Moritz Wildgruber - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • Sebastian Mönch - , Ludwig-Maximilians-Universität München (LMU) (Autor:in)
  • For The Save - (Autor:in)

Abstract

Background and Purpose The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population. Methods In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For model-ing of lifetime estimates, pediatric and adult input parameters were obtained from the current lit-erature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY. Results The model results yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives. Conclusions EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.

Details

OriginalspracheEnglisch
Seiten (von - bis)138-147
Seitenumfang10
Fachzeitschrift Journal of stroke : JoS
Jahrgang24
Ausgabenummer1
PublikationsstatusVeröffentlicht - Jan. 2022
Peer-Review-StatusJa

Externe IDs

ORCID /0000-0001-5258-0025/work/146644935

Schlagworte

Schlagwörter

  • Cost-benefit analysis, Pediatrics, Stroke, Thrombectomy

Bibliotheksschlagworte