Low-Intensity Monitoring for Mild-to-Moderate Acute Ischemic Stroke Is Cost Saving: Economic Evaluation for...

Area of Science:

• Health Economics
• Neurology
• Clinical Trials

Background:

• The OPTIMISTmain trial demonstrated the feasibility and safety of low-intensity monitoring versus standard monitoring for acute ischemic stroke patients receiving thrombolysis.
• This study aimed to evaluate the economic benefits of implementing low-intensity care in various healthcare systems.

Purpose of the Study:

• To estimate the cost-effectiveness of low-intensity monitoring compared to standard monitoring for acute ischemic stroke patients across multiple countries.
• To identify factors influencing the economic outcomes of different monitoring strategies.

Main Methods:

• A cost-minimization analysis was performed using data from the OPTIMISTmain trial.
• A decision tree model was developed and applied to Australia, China, Malaysia, the United Kingdom, the United States, and Vietnam.
• Cost data were sourced from existing literature, and analyses included univariate and probabilistic sensitivity assessments.

Main Results:

• Low-intensity monitoring demonstrated a high probability of cost savings in China (100%), the UK (100%), Australia (99.94%), and the US (95.91%).
• Patients under low-intensity monitoring incurred significant cost savings, ranging from US dollars 3 to 943 compared to the standard care group.
• Malaysia was an exception, with slightly higher costs for low-intensity monitoring. Higher ICU utilization correlated with greater cost savings.

Conclusions:

• Low-intensity monitoring is a cost-saving strategy, especially in countries with substantial intensive care resources for post-thrombolysis monitoring, like the United States.
• The economic benefits are linked to the proportion of patients requiring intensive care unit monitoring.