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Bart Jeroen Emmer¹, Victor Durieux², Johannes Kaesmacher³

¹Radiology and Nuclear Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands.

BMJ surgery, interventions, & health technologies

|August 18, 2025

概括

血管内血栓切除术 (EVT) 后的动脉内血栓溶解 (IA lysis) 是七个国家的经济有效的治疗选择. 这一发现支持IA溶解作为改善患者治疗结果和医疗保健经济学的有效策略.

科学领域:

神经学神经学
卫生经济学卫生经济学
干预性放射学干预性放射学

背景情况:

内血管血栓切除术 (EVT) 是急性缺血性中风的主要治疗方法.
辅助性动脉内血栓溶解 (IA溶解) 可能改善EVT后的结果.
在EVT之后IA溶解的成本效益需要评估.

研究的目的:

在成功EVT后评估额外IA溶解的成本效益.
估计IA溶解对质量调整寿命年 (QALYs) 和直接医疗成本的影响.

主要方法:

根据六个欧洲国家和美国公布的健康经济数据,开发了一种成本效益模型.
从CHOICE试验中获得的修改后兰金度量 (mRS) 得分提供了程序成本和长期护理估计的信息.
通过将mRS结果映射到EQ-5D实用值,在20年的时间范围内计算QALY,折扣为3%.

主要成果:

在所有七个研究国家中,EVT后的IA溶解被发现具有成本效益.
增量成本效益比率在2350美元/QALY (德国) 到9628美元/QALY (美国) 之间.
成本效益的可接受性在10,000美元至45,000美元之间的支付意愿值时达到90%.

结论:

在成功的EVT后,辅助IA溶解是研究国家的成本高效干预措施.
限制包括早期终止和CHOICE试验的小样本规模,影响了概括性.
建议进行进一步的大规模试验,以确认EVT后IA溶解的成本效益.

关键词:

医疗保健成本医疗保健成本医疗卫生技术技术技术神经干预装置的神经干预装置研究成果研究成果研究成果技术,放射学技术,放射学

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