Valutazione economica del trattamento con alteplase di pazienti con ictus ischemico in fase acuta, con riferimento all'Italia

Translated title of the contribution: Economic evaluation of alteplase for the treatment of acute ischaemic stroke in Italy

C. Lucioni, S. Mazzi, G. Micieli, M. L. Sacchetti, D. Toni

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Alteplase is a recombinant tissue-Plasminogen Activator (rt-PA) which can reduce disability in patients with acute ischaemic stroke. This study proposes a cost-effectiveness analysis, in the perspective of the Italian National Health Service. Methods: A life-time Markov model compares alteplase added to standard care versus standard care alone. Depending on treatment outcome, patients enter one of three health states: independent stroke, dependent stroke, and death. In each of the subsequent years, survivors may or may not face recurrence and be re-distributed in the above-mentioned states. The endpoint of the study is the cost per QALY (Quality Adjusted Life Year) gained (that is the incremental cost-effectiveness ratio [ICER]). With regard to costs, the study setting is Italy; treatment, hospitalization, ongoing care resources valuations are based on expert opinion data. Results: In the base case alteplase resulted a dominant strategy (costs saved per patient: €409). Both in the deterministic and probabilistic sensitivity analysis, alteplase dominance was confirmed in most cases. Conclusions: Compared with standard treatment, alteplase can be considered a dominant option for the treatment of acute ischaemic stroke in Italy. Such result appears robust when tested against uncertainty.

Translated title of the contributionEconomic evaluation of alteplase for the treatment of acute ischaemic stroke in Italy
Original languageItalian
Pages (from-to)91-103
Number of pages13
JournalPharmacoEconomics - Italian Research Articles
Volume12
Issue number2
Publication statusPublished - 2010

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Health Policy

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