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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
14:58

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Economic burden of intracranial vascular malformations in adults: prospective population-based study

Clare E Miller1, Zahidul Quayyum, Paul McNamee

  • 1Division of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK.

Stroke
|April 11, 2009
PubMed

Insights

Intracranial vascular malformations (IVMs) incur significant healthcare and lost productivity costs, particularly for brain arteriovenous malformations (AVMs) and those with intracerebral hemorrhage (ICH). Costs are highest for younger adults and those receiving interventional treatment.

Area of Science:

  • Neurology
  • Health Economics
  • Public Health

Background:

  • Intracranial vascular malformations (IVMs) are a primary cause of intracerebral hemorrhage (ICH) in young adults.
  • No prior cost-of-illness studies have been conducted on unselected cohorts of IVMs.

Purpose of the Study:

  • To determine the direct healthcare costs and indirect costs of lost productivity associated with brain arteriovenous malformations (AVMs) and cavernous malformations (CMs).
  • To analyze cost variations based on patient demographics, clinical presentation, and treatment interventions.

Main Methods:

  • A prospective, population-based study measured direct healthcare costs for 369 adults over 3 years post-diagnosis.
  • Indirect costs of lost productivity were estimated by projecting questionnaire responses from a subset of patients.
  • Costs included inpatient, outpatient, interventional, and brain imaging expenses.

Main Results:

  • Total 3-year healthcare costs reached £5.96 million, with AVMs accounting for 90% and inpatient care for 75%.
  • Median 3-year costs were significantly higher for patients with ICH, under 65 years, receiving interventions, and those with AVMs (£15,784) vs. CMs (£1385).
  • Projected 3-year lost productivity costs amounted to £8.7 million, with higher estimates for AVMs (£17,111) vs. CMs (£6752) per respondent.

Conclusions:

  • Intracranial vascular malformations represent a substantial economic burden due to healthcare and lost productivity costs.
  • Costs are disproportionately higher in younger patients (<65 years), those experiencing ICH, undergoing interventions, and with AVMs compared to CMs.
  • Further research on the cost-effectiveness of interventional treatments for IVMs is warranted.
Abstract

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