What absolute fucking stupidity! Survivors don't care about costs you blithering idiots! They want to know your 100% recovery statistics. GET THERE!
Cost-effectiveness of endovascular treatment after 6–24 h in ischaemic stroke patients with collateral flow on CT-angiography: A model-based economic evaluation of the MR CLEAN-LATE trial
Abstract
Background:
The
MR CLEAN-LATE trial has shown that patient selection for endovascular
treatment (EVT) in the late window (6–24 h after onset or
last-seen-well) based on the presence of collateral flow on
CT-angiography is safe and effective.(But does it get you to 100% recovery? The only goal in stroke? Or are you so fucking stupid you don't know that?)We aimed to assess the
cost-effectiveness of late-window collateral-based EVT-selection
compared to best medical management (BMM) over a lifetime horizon (until
95 years of age).
Materials and Methods:
A
model-based economic evaluation was performed from a societal
perspective in The Netherlands. A decision tree was combined with a
state-transition (Markov) model. Health states were defined by the
modified Rankin Scale (mRS). Initial probabilities at 3-months
post-stroke were based on MR CLEAN-LATE data. Transition probabilities
were derived from previous literature. Information on short- and
long-term resource use and utilities was obtained from a study using MR
CLEAN-LATE and cross-sectional data. All costs are expressed in 2022
euros. Costs and quality-adjusted life years (QALYs) were discounted at a
rate of 4% and 1.5%, respectively. The effect of parameter uncertainty
was assessed using probabilistic sensitivity analysis (PSA).
Results:
On
average, the EVT strategy cost €159,592 (95% CI: €140,830–€180,154) and
generated 3.46 QALYs (95% CI: 3.04–3.90) per patient, whereas the costs
and QALYs associated with BMM were €149,935 (95% CI: €130,841–€171,776)
and 2.88 (95% CI: 2.48–3.29), respectively. The incremental
cost-effectiveness ratio per QALY and the incremental net monetary
benefit were €16,442 and €19,710, respectively. At a cost-effectiveness
threshold of €50,000/QALY, EVT was cost-effective in 87% of
replications.
Discussion and Conclusion:
Collateral-based selection for late-window EVT is likely cost-effective from a societal perspective in The Netherlands.
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