Cost-Effectiveness Analysis of Tissue Plasminogen Activator for Acute Ischemic Stroke: A Comparative Review

Mei-Chiun Tseng ； Ku-Chou Chang

《Acta Neurologica Taiwanica》 13卷3期 (2004/09) Pp. 149-155

https://doi.org/10.29819/ANT.200409.0008

並列摘要

Purpose: This work was undertaken to review current evidence of cost-effectiveness analysis (CEA) on thrombolysis for acute ischemic stroke.
Methods: An electronic search via PubMed, from 1995 until May 2004, was performed. The methodsundertaken by these studies were examined with particular attention to their modeling assumptions, sources of data, and outcome measures.
Results: Three comprehensive CEAs of rtPA (recombinant tissue plasminogen activator) for acute ischemic troke were reviewed. These studies were from the United States, Canada, and the United Kingdom. All hese studies employed the perspective of a healthcare system and used a Markov decision-analytic modelling
approach. Estimates of effectiveness of rtPA were based on the National Institute of Neurological isorders and Stroke (NINDS) rtPA Stroke Trial, literature-derived values or a stroke registry. In each tudy, functional outcome measured by the modified Rankin Scale was used to represent health states, nd quality-adjusted life year gained was the health outcome summary measure. The cost-effectiveness of rtPA therapy varied in magnitude, but seemingly with same positive implications.
Conclusions: Cost-effectiveness analysis requires information on an intervention’s effectiveness and country-
specific sources of epidemiological and resource utilization data, most of which are not yet available n Taiwan. Despite the limitations, CEA is essential if a healthcare system would like to contain costs while maintaining, or improving, quality of care.

並列關鍵字

Review ； Cerebral infarction ； Tissue plasminogen activator ； Costs and cost analysis