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10.1136/svn-2016-000063

http://scihub22266oqcxt.onion/10.1136/svn-2016-000063
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suck abstract from ncbi


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pmid28736623
      Stroke+Vasc+Neurol 2017 ; 2 (2 ): 73-83
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  • A literature review of cost-effectiveness of intravenous recombinant tissue plasminogen activator for treating acute ischemic stroke #MMPMID28736623
  • Joo H ; Wang G ; George MG
  • Stroke Vasc Neurol 2017[]; 2 (2 ): 73-83 PMID28736623 show ga
  • BACKGROUND: Intravenous recombinant tissue plasminogen activator (IV rtPA) is recommended treatment for acute ischemic stroke patients, but the cost-effectiveness of IV rtPA within different time windows after the onset of acute ischemic stroke is not well reviewed. AIMS: To conduct a literature review of the cost-effectiveness studies about IV rtPA by treatment times. SUMMARY OF REVIEW: A literature search was conducted using MEDLINE, EMBASE, CINAHL and Cochrane Library, with the key words acute ischemic stroke, tissue plasminogen activator, cost, economic benefit, saving, and incremental cost-effectiveness analysis. The review is limited to original research articles published during 1995-2016 in English-language peer-reviewed journals. We found 16 studies meeting our criteria for this review. Nine of them were cost-effectiveness studies of IV rtPA treatment within 0-3 hours after stroke onset, 2 studies within 3-4.5 hours, 3 studies within 0-4.5 hours, and 2 study within 0-6 hours. IV rtPA is a cost-saving or a cost-effectiveness strategy from most of the study results. Only one study showed incremental cost-effectiveness ratio of IV rtPA within one year was marginally above $50,000 per QALY threshold. IV rtPA within 0-3 hours after stroke led to cost savings for lifetime or 30 years, and IV rtPA within 3-4.5 hours after stroke increased costs but still was cost-effective. CONCLUSIONS: The literature generally showed that intravenous IV rtPA was a dominant or a cost-effective strategy compared to traditional treatment for acute ischemic stroke patients without IV rtPA. The findings from the literature lacked generalizability because of limited data and various assumptions.
  • |*Drug Costs [MESH]
  • |Cost Savings [MESH]
  • |Cost-Benefit Analysis [MESH]
  • |Fibrinolytic Agents/*administration & dosage/adverse effects/*economics [MESH]
  • |Humans [MESH]
  • |Infusions, Intravenous [MESH]
  • |Ischemic Stroke/diagnosis/*drug therapy/*economics [MESH]
  • |Quality of Life [MESH]
  • |Quality-Adjusted Life Years [MESH]
  • |Thrombolytic Therapy/adverse effects/*economics [MESH]
  • |Time Factors [MESH]
  • |Time-to-Treatment/economics [MESH]
  • |Tissue Plasminogen Activator/*administration & dosage/adverse effects/*economics [MESH]


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