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Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial

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  • معلومة اضافية
    • Contributors:
      Institut Català de la Salut; Requena M, Molina CA, Ribo M Unitat d’Ictus, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vanden Bavière H, Verma S Chief Medical Office, Philips, Amsterdam, The Netherlands. Gerrits C, Kokhuis T Image Guided Therapy, Philips Healthcare, Best, The Netherlands. Tomasello A Unitat d’Ictus, Servei de Neurologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain; Vall d'Hebron Barcelona Hospital Campus
    • بيانات النشر:
      BMJ
    • الموضوع:
      2024
    • نبذة مختصرة :
      Angiography; Stroke; Thrombectomy ; Angiografía; Ictus; Trombectomía ; Angiografia; Ictus; Trombectomia ; Background The ANGIOCAT trial showed a clinical benefit of direct to angiography suite (DTAS) for patients with large vessel occlusion (LVO) stroke admitted within 6 hours after symptom onset in decreased hospital workflow time and improved clinical outcome. However, the impact of DTAS implementation on hospital costs is unknown. This economic evaluation aims to assess the cost-utility of DTAS from the provider (hospital) perspective. Methods A cost-utility analysis was applied to compare DTAS with the standard direct to CT (DTCT) suite approach using direct cost and health outcomes data. The time horizon was 90 days. One-way sensitivity analysis as well as probabilistic sensitivity analysis was performed, varying the model parameters by ±25%. Measures included costs, quality-adjusted life years, and incremental cost-effectiveness ratios. Health outcomes, classified according to the modified Rankin Scale, were obtained from the ANGIOCAT trial. Respective utilities were obtained from the literature. Results DTAS is the dominant strategy. The incremental cost-effectiveness ratio is −€89 110 (−$97 600) with cost saving per patient of –€2848 (–$3120). The improved clinical outcome is directly related with a decrease in costs for the hospital, mainly due to the decrease in costs of hospital stay, improved clinical outcome and fewer complications. Conclusions For patients with LVO admitted within 6 hours after symptom onset, the DTAS not only improves clinical outcome but also decreases the costs (dominant option) compared with the standard DTCT. Multicentric international randomized clinical trials are ongoing to determine the replicability of our findings. ; The research was supported by Philips.
    • File Description:
      application/pdf
    • ISSN:
      1759-8478
    • Relation:
      Journal of NeuroInterventional Surgery;16(2); https://doi.org/10.1136/jnis-2023-020275; Requena M, Bavière H Vanden, Verma S, Gerrits C, Kokhuis T, Tomasello A, et al. Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial. J Neurointerv Surg. 2024 Feb;16(2):138–42.; https://hdl.handle.net/11351/10929; 000981487100001
    • الرقم المعرف:
      10.1136/jnis-2023-020275
    • الدخول الالكتروني :
      https://hdl.handle.net/11351/10929
      https://doi.org/10.1136/jnis-2023-020275
    • Rights:
      Attribution-NonCommercial 4.0 International ; http://creativecommons.org/licenses/by-nc/4.0/ ; info:eu-repo/semantics/openAccess
    • الرقم المعرف:
      edsbas.C9EB36F0