Deans' stroke musings: Regional and national differences in stroke thrombolysis use and disparities in pricing, treatment availability, and coverage

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, March 21, 2022

Regional and national differences in stroke thrombolysis use and disparities in pricing, treatment availability, and coverage

Since we have NO STROKE LEADERSHIP that will fix this problem,it is YOUR responsibility to have your stroke in the correct place to get treated at least semi-properly.

Regional and national differences in stroke thrombolysis use and disparities in pricing, treatment availability, and coverage

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Ana Claudia de Souza

, Ivy Anne Sebastian, Wan Asyraf Wan Zaidi, ...

First Published March 18, 2022 Research Article Find in PubMed

Abstract

Background:

Major disparities have been reported in recombinant tissue plasminogen activator (rtPA) availability among countries of different socioeconomic status.

Aims:

To characterize variability of rtPA price, its availability, and its association with and impact on each country’s health expenditure (HE) resources.

Methods:

We conducted a global survey to obtain information on rtPA price (50 mg vial, 2020 US Dollars) and availability. Country-specific data, including low, lower middle (LMIC), upper middle (UMIC), and high-income country (HIC) classifications, and gross domestic product (GDP) and HE, both nominally and adjusted for purchasing power parity (PPP), were obtained from World Bank Open Data. To assess the impact of rtPA cost, we computed the rtPA price as percentage of per capita GDP and HE and examined its association with the country income classification.

Results:

rtPA is approved and available in 109 countries. We received surveys from 59 countries: 27 (46%) HIC, 20 (34%) UMIC, and 12 (20%) LMIC. Although HIC have significantly higher per capita GDP and HE compared to UMIC and LMIC (p < 0.0001), the median price of rtPA is non-significantly higher in LMICs (USD 755, interquartile range, IQR (575–1300)) compared to UMICs (USD 544, IQR (400–815)) and HICs (USD 600, IQR (526–1000)). In LMIC, rtPA cost accounts for 217.4% (IQR, 27.1–340.6%) of PPP-adjusted per capita HE, compared to 17.6% (IQR (11.2–28.7%), p < 0.0001) for HICs.

Conclusion:

We documented significant variability in rtPA availability and price among countries. Relative costs are higher in lower income countries, exceeding the available HE. Concerted efforts to improve rtPA affordability in low-income settings are necessary.

Keywords

Ischemic stroke, thrombolysis, rtPA, drug cost, availability