PCV52 COST-EFFECTIVNESS STUDY OF CITICOLINE IN PATIENTS WITH ACUTE ISCHEMIC STROKE IN RUSSIA

Abstract

Cerebrovascular diseases are on the second place among all causes of death in Russia. Neuroprotective therapy is one of the main approaches of therapy in patients with acute ischemic stroke in Russia despite the absence of this group of medicines in the recommendations of national standard of care in stroke (GOST R 200). The objective of this research was to evaluate cost-effectiveness ratio for the use of citicolin (a neuroprotective agent widely used in some EU countries, South Korea, Russia and some other countries) in patients treated according to the national standard of care in stroke (GOST R 200). The data on the efficacy of citicolin in patients with acute ischemic stroke were extracted from pooling analysis of clinical trials “Oral citicolin in acute stroke” (Davalos A. et al., 2002) The clinical effect was measured as global recovery index (proportion of patients with full recovery during 3 months). Cost of treatment with citicolin and cost-effectiveness ratio (CER) were calculated from the point of view of the Russian state health care system. According to the results of the above mentioned pooling analysis, the use of citicoline in stroke patients was associated with significantly greater rate of recovery than placebo (OR,1.33; 95% CI, 1.10 to 1.62). Costs of treatment of acute ischemic stroke according to recommendations of the national standard plus citicolin was 1 715.5 USD per 3 months. Costs of the treatment without citicolin was 1 289 USD per 3 months. CER (i.e. direct costs per one fully recovery patient) treated with citicolin and placebo were 6 354 USD and 6 384 USD respectively. Incremental CER was 6 264 USD. According to the applied model a treatment, citicolin appeared to demonstrate its clinically efficacy and cost-effectiveness in treatment of the patients with acute ischemic stroke, compared to placebo.