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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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Published on: August 18, 2015

The economic case for new stroke thrombolytics.

S Claiborne Johnston1

  • 1Department of Neurology, University of California, San Francisco, CA 94143-0114, USA. clay.johnston@ucsfmedctr.org

Stroke
|September 30, 2010
PubMed
Summary

Tissue plasminogen activator (tPA) offers significant health and economic benefits for ischemic stroke patients in the US. Developing improved thrombolytics could yield greater societal impact and justify increased investment.

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Area of Science:

  • Pharmacoeconomics
  • Health Economics
  • Stroke Medicine

Background:

  • Tissue plasminogen activator (tPA) is a key treatment for ischemic stroke.
  • Assessing the societal costs and health benefits of tPA is crucial for population health and economic analysis.
  • Modeling the impact of novel thrombolytics with enhanced efficacy or safety profiles is essential.

Purpose of the Study:

  • To model the societal costs and health benefits of tPA for ischemic stroke in the US population.
  • To evaluate the potential economic impact of new thrombolytics with improved characteristics.
  • To determine the cost-effectiveness and revenue potential of tPA and next-generation stroke treatments.

Main Methods:

  • A systematic review identified pertinent publications on tPA utilization, societal cost, and health impact.
  • Data on tPA utilization were integrated with per-use cost and health impact data (in 2004 dollars).
  • Model inputs were adjusted to simulate the effects of new thrombolytics with varied efficacy, safety, and eligibility criteria.

Main Results:

  • Current tPA use yields $6074 in savings and 0.75 quality-adjusted life year (QALY) per use.
  • At a $50,000/QALY benchmark, tPA pricing at $45,800/dose could generate $458 million annually.
  • Improved thrombolytics or extended time windows could offer greater revenue potential at accepted cost-effectiveness levels.

Conclusions:

  • tPA provides significant health and economic advantages for ischemic stroke treatment in the US.
  • Development of superior thrombolytics for stroke holds considerable societal benefit.
  • Potential financial returns for developers appear sufficient to warrant increased investment in novel stroke drug candidates.