Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study
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Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study. / Kunz, Wolfgang G; Sporns, Peter B; Psychogios, Marios N; Fiehler, Jens; Chapot, René; Dorn, Franziska; Grams, Astrid; Morotti, Andrea; Musolino, Patricia; Lee, Sarah; Kemmling, André; Henkes, Hans; Nikoubashman, Omid; Wiesmann, Martin; Jensen-Kondering, Ulf; Möhlenbruch, Markus; Schlamann, Marc; Marik, Wolfgang; Schob, Stefan; Wendl, Christina; Turowski, Bernd; Götz, Friedrich; Kaiser, Daniel; Dimitriadis, Konstantinos; Gersing, Alexandra; Liebig, Thomas; Ricke, Jens; Reidler, Paul; Wildgruber, Moritz; Mönch, Sebastian; Save ChildS Pro Investigators.
In: J STROKE, Vol. 24, No. 1, 01.2022, p. 138-147.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study
AU - Kunz, Wolfgang G
AU - Sporns, Peter B
AU - Psychogios, Marios N
AU - Fiehler, Jens
AU - Chapot, René
AU - Dorn, Franziska
AU - Grams, Astrid
AU - Morotti, Andrea
AU - Musolino, Patricia
AU - Lee, Sarah
AU - Kemmling, André
AU - Henkes, Hans
AU - Nikoubashman, Omid
AU - Wiesmann, Martin
AU - Jensen-Kondering, Ulf
AU - Möhlenbruch, Markus
AU - Schlamann, Marc
AU - Marik, Wolfgang
AU - Schob, Stefan
AU - Wendl, Christina
AU - Turowski, Bernd
AU - Götz, Friedrich
AU - Kaiser, Daniel
AU - Dimitriadis, Konstantinos
AU - Gersing, Alexandra
AU - Liebig, Thomas
AU - Ricke, Jens
AU - Reidler, Paul
AU - Wildgruber, Moritz
AU - Mönch, Sebastian
AU - Save ChildS Pro Investigators
PY - 2022/1
Y1 - 2022/1
N2 - BACKGROUND AND PURPOSE: The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population.METHODS: In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For modeling of lifetime estimates, pediatric and adult input parameters were obtained from the current literature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY.RESULTS: The model.RESULTS: yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives.CONCLUSIONS: EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.
AB - BACKGROUND AND PURPOSE: The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population.METHODS: In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For modeling of lifetime estimates, pediatric and adult input parameters were obtained from the current literature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY.RESULTS: The model.RESULTS: yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives.CONCLUSIONS: EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.
U2 - 10.5853/jos.2021.01606
DO - 10.5853/jos.2021.01606
M3 - SCORING: Journal article
C2 - 35135067
VL - 24
SP - 138
EP - 147
JO - J STROKE
JF - J STROKE
SN - 2287-6391
IS - 1
ER -
