Cost-effectiveness analysis of mechanical thrombectomy plus tissue-type plasminogen activator compared with tissue-type plasminogen activator alone for acute ischemic stroke in France
| dc.rights.license | open | en_US |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | KABORE, Nathanael | |
| dc.contributor.author | MARNAT, G. | |
| dc.contributor.author | ROUANET, Francois | |
| dc.contributor.author | BARREAU, X. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | VERPILLOT, Elise | |
| dc.contributor.author | MENEGON, P. | |
| dc.contributor.author | MAACHI, I. | |
| dc.contributor.author | BERGE, J. | |
| hal.structure.identifier | Institut de Neurosciences cognitives et intégratives d'Aquitaine [INCIA] | |
| dc.contributor.author | SIBON, Igor | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | BENARD, Antoine | |
| dc.date.accessioned | 2020-06-25T09:37:00Z | |
| dc.date.available | 2020-06-25T09:37:00Z | |
| dc.date.issued | 2019-04 | |
| dc.identifier.issn | 0035-3787 (Print) 0035-3787 (Linking) | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/8194 | |
| dc.description.abstractEn | BACKGROUND AND PURPOSE: Recent studies demonstrated the benefit of mechanical thrombectomy (MT) plus intravenous tissue-type plasminogen activator (IV-tPA) (MT-IV-tPA) in acute ischemic stroke. This study aimed to estimate the cost-utility of MT-IV-tPA compared with IV-tPA alone from the perspective of the French National Health Insurance. METHODS: We developed a decision tree for the first 3 months after stroke onset and a Markov model until 10 years post-stroke. The health states of the Markov model were according to the modified Rankin Scale (mRS): independent (mRS=0-2), dependent (mRS=3-5), dead (mRS=6). Recurrent stroke was the fourth health stage of our model. We conducted systematic literature reviews and meta-analyses to estimate the cost and utility of each health state, and the transition probabilities between health states. A microcosting study was conducted to estimate the cost of MT. We estimated the incremental cost-effectiveness ratio of MT-IV-tPA and conducted a probabilistic analysis in order to estimate the probability that MT-IV-tPA is cost-effective compared to IV-tPA, the expected value of perfect information (EVPI), and the expected value of partial perfect information (EVPPI), given the uncertainty surrounding the value of our model's parameters. RESULTS: The total mean (standard deviation (SD) cost of MT was euro6708.9 (2357.0). The incremental cost-effectiveness ratio (ICER) of the strategy using IV-tPA combined to MT costs was euro14,715 per QALY gained as compared to a strategy using IV-tPA alone. The probabilistic analysis showed that the probability of MT-IV-TPA being cost-effective was 85.4% at threshold willingness-to-pay of euro30,000 per QALY gained, reaching 98% at euro50,000 per QALY gained. CONCLUSION: Although there is no universally accepted willingness-to-pay threshold in France, our analysis suggest that MT combined to IV-tPA can be considered a cost-effective treatment compared with IV-tPA alone. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | USMR | |
| dc.subject.en | EMOS | |
| dc.subject.en | CIC1401 | |
| dc.title.en | Cost-effectiveness analysis of mechanical thrombectomy plus tissue-type plasminogen activator compared with tissue-type plasminogen activator alone for acute ischemic stroke in France | |
| dc.title.alternative | Rev Neurol (Paris) | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1016/j.neurol.2018.06.007 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 30642680 | en_US |
| bordeaux.journal | Revue Neurologique | en_US |
| bordeaux.page | 252-260 | en_US |
| bordeaux.volume | 175 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - U1219 | en_US |
| bordeaux.issue | 4 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-03209396 | |
| hal.version | 1 | |
| hal.date.transferred | 2021-04-27T08:52:41Z | |
| hal.export | true | |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Revue%20Neurologique&rft.date=2019-04&rft.volume=175&rft.issue=4&rft.spage=252-260&rft.epage=252-260&rft.eissn=0035-3787%20(Print)%200035-3787%20(Linking)&rft.issn=0035-3787%20(Print)%200035-3787%20(Linking)&rft.au=KABORE,%20Nathanael&MARNAT,%20G.&ROUANET,%20Francois&BARREAU,%20X.&VERPILLOT,%20Elise&rft.genre=article |
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