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预算影响分析:重组组织型纤溶酶原激活剂(rtPA)治疗哥伦比亚急性缺血性脑卒中的成本。

Budgetary impact analysis of alteplase - recombinant tissue plasminogen activator (rtPA) - as a thrombolytic treatment for acute ischemic stroke in Colombia.

机构信息

Department of Economic Studies, Neuroeconomix, Bogota, Colombia.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2022 Oct;22(7):1095-1102. doi: 10.1080/14737167.2022.2089655. Epub 2022 Jun 16.

Abstract

INTRODUCTION

Thrombolysis is effective for treating acute ischemic stroke (AIS). Trials have evaluated its effectiveness at different timepoints after stroke. The objective of the study was to evaluate the clinical and budgetary impact of increasing the proportion of thrombolyzed acute ischemic stroke patients in Colombia.

METHODS

The budgetary impact was estimated for a 5-year time horizon from the perspective of the third-party payer. Costs were estimated using local standardized methods and expressed in US dollars of 2020. We compared two scenarios: a current one and an alternative one, with doubled thrombolysis access.

RESULTS

The increase in thrombolyzed patients would decrease the number of patients with sequelae by 1,721, 2,594 and 1,007 in the ranges of 0-90 minutes, 91-180 and 181-270, respectively. The budget effort increase for each of the treatment initiation ranges is of USD$15,525,649(+5.5%), USD$16,665,304(+5.7%) and USD$16,963,231(+7.0%), respectively.

CONCLUSIONS

Doubling the number of patients with AIS who are thrombolyzed would lead to reductions in the number of patients with sequelae and would require a budgetary effort of 5.5-7.0%. The early initiation of treatment gives an additional benefit in reducing the number of sequelae and a lower budgetary impact than initiation within the later time window.

摘要

简介

溶栓治疗对急性缺血性脑卒中(AIS)有效。试验已经评估了在脑卒中后不同时间点的溶栓效果。本研究的目的是评估在哥伦比亚增加溶栓治疗 AIS 患者比例的临床和预算影响。

方法

从第三方支付者的角度,对 5 年时间跨度的预算影响进行了估计。成本使用当地标准化方法进行估计,并以 2020 年的美元表示。我们比较了两种情况:当前情况和替代情况,即溶栓治疗途径增加一倍。

结果

增加溶栓治疗的患者数量将分别减少 0-90 分钟、91-180 分钟和 181-270 分钟范围内的后遗症患者数量 1721、2594 和 1007 人。每个治疗开始范围的预算增加额分别为 15525649 美元(增加 5.5%)、16665304 美元(增加 5.7%)和 16963231 美元(增加 7.0%)。

结论

将接受溶栓治疗的 AIS 患者数量增加一倍,将减少后遗症患者数量,并需要 5.5-7.0%的预算投入。尽早开始治疗可额外减少后遗症的发生,并降低预算影响,而晚期开始治疗的影响则更小。

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