Cost-Effectiveness of an Individualised Management Program after Stroke: A Trial-Based Economic Evaluation

Area of Science:

• Health Economics
• Public Health
• Neurology

Background:

• Limited evidence exists on the cost-effectiveness of comprehensive post-stroke programs.
• This study assesses the cost-effectiveness of an individualized management program (IMP) for stroke or transient ischemic attack (TIA).

Purpose of the Study:

• To evaluate the cost-effectiveness of an individualized management program (IMP) compared to usual care (UC) for patients with stroke or TIA.
• To analyze costs and quality-adjusted life years (QALYs) from both societal and health system perspectives over a 24-month follow-up period.

Main Methods:

• A cost-utility analysis was conducted alongside a randomized controlled trial with 502 participants.
• The IMP involved stroke-specific nurse-led education and specialist care plan reviews, with telephone follow-ups.
• Costs and QALYs were analyzed from societal and health system perspectives, with costs discounted at 5% beyond 12 months.

Main Results:

• From a societal perspective, the IMP was dominant in 52.7% of iterations, showing lower costs and higher QALYs than UC.
• The probability of cost-effectiveness from a societal perspective was 60.5%, with a mean per-person cost of AUD 49,045.
• From a health system perspective, the incremental cost per QALY gained was AUD 53,175, with cost-effectiveness in 46.7% of iterations.

Conclusions:

• Individualized management programs for stroke/TIA patients are cost-effective from a societal perspective over 24 months.
• Economic evaluations of stroke prevention programs require adequate time horizons and consideration of broader societal costs to demonstrate value.