การวิเคราะห์ต้นทุนอรรถประโยชน์ของการรักษาผู้ป่วยโรคหลอดเลือดสมองตีบหรืออุดตันระยะเฉียบพลันด้วยสายสวนหลอดเลือดสมอง

Thanaboon Worakijthamrongchai; Prasutr Thawornchaisit; Sukhontha Kongsin

Authors

Thanaboon Worakijthamrongchai Neurological Institute of Thailand, Department of Medical Services, Ministry of Public Health
Prasutr Thawornchaisit Institute of Medical Research and Technology Assessment, Department of Medical Services, Ministry of Public Health
Sukhontha Kongsin Department of Public Health Administration, Faculty of Public Health, Mahidol University

Keywords:

mechanical thrombectomy, intravenous thrombolysis, acute ischemic stroke, cost utility

Abstract

The mechanical thrombectomy (MT) is the established standard and effective treatment for large vessel occluded stroke patients. This research aimed to analyze whether MT was cost-effective when compared with intravenous thrombolysis (IVT). This was a retrospective cohort study, reviewing medical records of acute ischemic stroke patients with large vessel occlusion during 2015-2020. The study included 106 stroke patients treated with MT (n=66) versus IVT (n=40). The total cost of MT and IVT were estimated at 568,587 baht and 121,582 baht, respectively. Both male and female patients treated with MT had a greater quality-adjusted life years (QALYs) compared to those treated with IVT. The incremental cost-effectiveness ratios for male and female patients treated with MT were 99,184 and 82,715 baht per QALY gained, respectively. Conclusion: This study demonstrates that MT was cost-effective for treating acute ischemic stroke judging against the willingness to pay of 160,000 baht per QALY of Thailand.

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