Unknown

Dataset Information

0

Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).


ABSTRACT: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions.In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke), in-trial costs were measured for patients using detailed medical resource utilization and hospital billing data. Utility weights were assessed at 30 and 90 days using the EuroQol-5 dimension questionnaire. Post-trial costs and life-expectancy were estimated for each surviving patient using a model based on trial data and inputs derived from a contemporary cohort of ischemic stroke survivors.Index hospitalization costs were $17?183 per patient higher for SST+tPA than for tPA ($45?761 versus $28?578; P<0.001), driven by initial procedure costs. Between discharge and 90 days, costs were $4904 per patient lower for SST+tPA than for tPA ($11?270 versus $16?174; P=0.014); total 90-day costs remained higher with SST+tPA ($57?031 versus $44?752; P<0.001). Higher utility values for SST+tPA led to higher in-trial quality-adjusted life years (0.131 versus 0.105; P=0.005). In lifetime projections, SST+tPA was associated with substantial gains in quality-adjusted life years (6.79 versus 5.05), cost savings of $23?203 per patient and was economically dominant when compared with tPA in 90% of bootstrap replicates.Among patients with acute ischemic stroke enrolled in the SWIFT-PRIME trial, SST increased initial treatment costs, but was projected to improve quality-adjusted life-expectancy and reduce healthcare costs over a lifetime horizon compared with tPA.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01657461.

SUBMITTER: Shireman TI 

PROVIDER: S-EPMC5461963 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

altmetric image

Publications

Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).

Shireman Theresa I TI   Wang Kaijun K   Saver Jeffrey L JL   Goyal Mayank M   Bonafé Alain A   Diener Hans-Christoph HC   Levy Elad I EI   Pereira Vitor M VM   Albers Gregory W GW   Cognard Christophe C   Hacke Werner W   Jansen Olav O   Jovin Tudor G TG   Mattle Heinrich P HP   Nogueira Raul G RG   Siddiqui Adnan H AH   Yavagal Dileep R DR   Devlin Thomas G TG   Lopes Demetrius K DK   Reddy Vivek K VK   du Mesnil de Rochemont Richard R   Jahan Reza R   Vilain Katherine A KA   House John J   Lee Jin-Moo JM   Cohen David J DJ  

Stroke 20161227 2


<h4>Background and purpose</h4>Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions.<h4>Methods</h4>In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention fo  ...[more]

Similar Datasets

| S-EPMC5841644 | biostudies-literature
| S-EPMC3521799 | biostudies-literature
| S-EPMC7564150 | biostudies-literature
| S-EPMC6123376 | biostudies-literature
| S-EPMC4138310 | biostudies-literature
| S-EPMC10569475 | biostudies-literature
| S-EPMC5822198 | biostudies-literature
| S-EPMC3299943 | biostudies-literature
| S-EPMC6540520 | biostudies-literature
| S-EPMC10205869 | biostudies-literature