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Modeling the Cost Effectiveness of Neuroimaging-Based Treatment of Acute Wake-Up Stroke

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  • Ankur Pandya
  • Ashley A Eggman
  • Hooman Kamel
  • Ajay Gupta
  • Bruce R Schackman
  • Pina C Sanelli

Abstract

Background: Thrombolytic treatment (tissue-type plasminogen activator [tPA]) is only recommended for acute ischemic stroke patients with stroke onset time 4.5 hours, 46.3% experienced a good stroke outcome. Lifetime discounted QALYs and costs were 5.312 and $88,247 for the no treatment strategy and 5.342 and $90,869 for the MRI-based strategy, resulting in an ICER of $88,000/QALY. Results were sensitive to variations in patient- and provider-specific factors such as sleep duration, hospital travel and door-to-needle times, as well as onset probability distribution, MRI specificity, and mRS utility values. Conclusions: Our model-based findings suggest that an MRI-based treatment strategy for this population could be cost-effective and quantifies the impact that patient- and provider-specific factors, such as sleep duration, hospital travel and door-to-needle times, could have on the optimal decision for wake-up stroke patients.

Suggested Citation

  • Ankur Pandya & Ashley A Eggman & Hooman Kamel & Ajay Gupta & Bruce R Schackman & Pina C Sanelli, 2016. "Modeling the Cost Effectiveness of Neuroimaging-Based Treatment of Acute Wake-Up Stroke," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-13, February.
    • Handle: RePEc:plo:pone00:0148106
    DOI: 10.1371/journal.pone.0148106
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    References listed on IDEAS

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