How a thrombectomy service can reduce hospital deficit: a cost-effectiveness study

Area of Science:

• Neurology
• Interventional Neurology
• Health Economics

Background:

• Level 1 evidence supports cerebral thrombectomy for acute large vessel occlusion.
• Hospitals are implementing this life-saving stroke treatment.
• The initial cost of thrombectomy is high, but its health economic benefits require detailed patient-level costing.

Purpose of the Study:

• To perform patient-level costing for mechanical thrombectomy within the first hospital episode and up to 90 days post-event.
• To determine the cost-effectiveness of mechanical thrombectomy in acute large vessel occlusion stroke.

Main Methods:

• Retrospective analysis of 50 acute stroke patients.
• Coarsened exact matched-pair analysis comparing thrombectomy patients with controls.

Main Results:

• Mechanical thrombectomy significantly improved functional outcomes (mRS 0-2) compared to controls (56% vs 8%).
• Thrombectomy patients had shorter hospital stays, fewer adverse events, and reduced rehabilitation needs, including significantly fewer physiotherapy sessions.
• Overall median costs were lower for thrombectomy patients (£22,444 vs £39,664), resulting in median savings of £17,221 per patient.

Conclusions:

• Mechanical thrombectomy enhances patient outcomes and reduces hospitalisation duration.
• Despite initial costs, mechanical thrombectomy significantly reduces overall treatment costs for hospitals, even without procedural reimbursement.