Calculation of prevalence with Markov models: budget impact analysis of thrombolysis for stroke

The objective is to develop a method for calculating the prevalence of stroke based on Markov models and to apply it to the assessment of the budget impact analysis of thrombolytic treatment.

A Markov model was used to reproduce the natural history of stroke. The first step was to run the model to build the sojourn matrix from the initial population vector. The second step was to ascertain the number of individuals in the origin of each annual cohort. Finally, prevalence figures were obtained, validated, and used to calculate the impact of treatment with thrombolysis in 10% of patients with stroke in the Basque Country as if thrombolysis had begun in 2000 and would continue to 2015.

Stroke prevalence rates per 100,000 for the entire population are 898 for men and 686 for women, with a combined rate of 774 for men and women. Rates for stroke-related disability are 358 per 100,000 for men, 275 for women, and 309 for men and women combined. If 10% of the stroke patients would have received thrombolytic treatment from 2000 to 2015, the number of disabled in 2015 would be reduced by 328, and the net savings for the Basque society (2,100,000 inhabitants) would be 1.7 million euro.

The budget impact analysis of thrombolysis for stroke starting in 2000 shows a positive impact on the health budget because it saves costs after 2006 and produces a net benefit in health from the beginning of treatment.