PMD56 - COST OF STENT-RETRIEVER MECHANICAL THROMBECTOMY IN PATIENTS WITH ISCHEMIC STROKE IN THE RUSSIAN FEDERATION

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To evaluate the cost of stent-retriever mechanical thrombectomy (MTE) in patients with acute ischemic stroke (AIS) from the Russian government perspective. The model was developed to simulate health outcomes and associated costs of three treatment scenarios: 1) MTE added to thrombolytic therapy (MTE + TLT); 2) MTE alone; 3) no reperfusion. Direct medical, direct non-medical and indirect costs due to AIS and its consequences were calculated for 5 years horizon. Number of patients eligible for reperfusion was estimated on the base of available data on epidemiology of AIS in RF. Patients were considered eligible for all 3 scenarios if they were taken to hospital within 4.5 hours after stroke onset, or for scenarios 2 and 3 if they were hospitalized within 6 hours. Outcome data on functional independence, disability or death were taken from meta-analysis of Campbell BC et al., 2016. The sensitivity analyses was carried out. When MTE+TLT is performed within 4.5 hours after stroke onset, AIS burden comprises 16.7 mln EURO. In the absence of reperfusion or MTE only the burden is 21.4 and 18.9 mln EURO, respectively. If MTE takes place within 6 hours after stroke onset, the economic burden of AIS is 24.2 mln EURO, that is 1.8 mln EURO less than when reperfusion is not performed. MTE + TLT or MTE alone lead to a reduction in the overall economic burden of AIS since the 2nd year after acute disease. Decrease of direct non-medical and indirect costs due to disability and death compensates increase in direct medical costs. The investments into MTE were fully covered on the 5th year. The use of MTE + TLT or MTE alone in patients with AIS is an efficient option of AIS treatment in Russia due to the decrease of direct non-medical and indirect costs.