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Economic analysis of the 'Take Charge' intervention for people following stroke: Results from a randomised trial
Braden Te Ao1, Matire Harwood1, Vivian Fu2
1University of Auckland, Auckland, New Zealand.
Objective:
To undertake an economic analysis of the Take Charge intervention as part of the Taking Charge after Stroke (TaCAS) study.
Design:
An open, parallel-group, randomised trial comparing active and control interventions with blinded outcome assessment.
Setting:
Community.
Participants:
Adults (n = 400) discharged to community, non-institutional living following acute stroke.
Interventions:
The Take Charge intervention, a strengths based, self-directed rehabilitation intervention, in two doses (one or two sessions), and a control intervention (no Take Charge sessions).
Measures:
The cost per quality-adjusted life year (QALY) saved for the period between randomisation (always post hospital discharge) and 12 months following acute stroke. QALYs were calculated from the EuroQol-5D-5L. Costs of stroke-related and non-health care were obtained by questionnaire, hospital records and the New Zealand Ministry of Health.
Results:
One-year post hospital discharge cost of care was mean (95% CI) $US4706 (3758-6014) for the Take Charge intervention group and $6118 (4350-8005) for control, mean (95% CI) difference $ -1412 (-3553 to +729). Health utility scores were mean (95% CI) 0.75 (0.73-0.77) for Take Charge and 0.71 (0.67-0.75) for control, mean (95% CI) difference 0.04 (0.0-0.08). Cost per QALY gained for the Take Charge intervention was $US -35,296 (=£ -25,524, € -30,019). Sensitivity analyses confirm Take Charge is cost-effective, even at a very low willingness-to-pay threshold. With a threshold of $US5000 per QALY, the probability that Take Charge is cost-effective is 99%.
Conclusion:
Take Charge is cost-effective and probably cost saving.
