PCV40 COST AND PRACTICE OF TREATMENT OF ACUTE ISCHEMIC STROKE IN REAL WORLD SETTINGS IN RUSSIA

Abstract

To evaluate typical practice and cost of treatment patients with acute ischemic stroke in leading medical hospitals in Russia, to compare treatment patterns and cost of treatment in “real world settings” and according to national standard of care in stroke. Retrospective analysis of case records of patients with acute ischemic stroke. Treatment patterns in “real world settings” and according to national standard of care in stroke were compared. Direct cost of treatment was estimated from state health care system point of view. Data from 140 case records was retrieved. Significant inconsistencies in the list of medicines between protocol of care and typical practice have been identified. Particularly, the frequency prescription of anticonvulsants and myorelaxants in real world settings was lower than in protocol. Low frequency of psychological (0%- in typical practice, 80% - in protocol) and rehabilitation methods of treatment (33% - in typical practice, 70-80% - in protocol) was revealed. Patients also didn't receive prophylactics of tromboembolism (6% - in typical practice, 80% - in protocol). Average total cost of treatment of one patient with ischemic stroke in typical practice was 905 dollars (302 dollars – cost of drug therapy, 187 dollars – cost of medical diagnostic and therapeutic services, 416 dollars – accommodation costs). Average period of inpatient stay was 20 days. Average total cost of treatment of one patients with ischemic stroke according to the protocol was 1 446 dollars (322 dollars – cost of drug therapy, 686 dollars – cost of diagnostic and therapeutic services, 438 dollars - accommodation costs). Significant inconsistencies of management patterns in patients with ischemic stroke in typical practice and national standard have been revealed. Direct costs of inpatient care in typical practice are approximately twice lower than costs calculated from national protocol of care.