Endovascular treatment for basilar artery occlusion: a cost-effectiveness analysis based on a meta-analysis

作者：Li Wang, Ying Yu, Limei Zhou, Ping Xu, Xianbin Guo, Yu Xie, Junxiu Cai, Min Pan, Jie Tang, Qingtao Gong, Rong Su, Yake Lou, Yan Liu · 发表于：Frontiers in Neurology · 年份：2023 · DOI：10.3389/fneur.2023.1267554 · 被引用次数：3 · 研究领域：Acute Ischemic Stroke Management、Spatial Neglect and Hemispheric Dysfunction、Peripheral Artery Disease Management

Objective This study aimed to investigate the efficacy and economic effect of endovascular treatment (EVT) combined with standard medical treatment (SMT) vs. SMT alone in Chinese patients with basilar artery occlusion (BAO) from the perspective of the Chinese healthcare system. Methods We conducted a cost-effectiveness analysis using the results from a meta-analysis comparing EVT and SMT efficacy in Chinese patients with BAO-induced stroke using direct medical costs from the China National Stroke Registry. The meta-analysis’s primary outcome was excellent functional outcome (mRS scores of 0–2), with secondary outcomes being poor functional outcome (mRS scores of 3–5) and death (mRS score of 6). To compare EVT plus SMT’s cost-effectiveness with that of SMT alone, we constructed a combined decision tree and Markov model with a lifetime duration and a 3-month cycle length. The primary cost-effectiveness outcome was the incremental cost-effectiveness ratio (ICER), representing the incremental cost per incremental quality-adjusted life year (QALY). EVT was considered cost-effective if the ICER was lower than the willingness-to-pay (WTP) threshold of three times the per capita gross domestic product (GDP) in 2021 in China; otherwise, it would not be cost-effective. Results The meta-analysis results indicated that EVT could increase the incidence of excellent functional outcomes, with a risk ratio (RR) of 2.23 (95% confidence interval, CI, 1.18–4.21), p = 0.01. Simultaneously, EVT r...