Background: Updating pharmacoeconomics of stroke in the past 5 years from Europe, the Americas, and the Pacific Area. This ischemic stroke study relates to telestroke and stroke care. To evaluate the extent and economic quality of published ischemic stroke economic evaluation especially in telestroke and stroke care in the past 5 years. Methods: A systematic review was conducted according to PRISMA guidelines.. The inclusion criteria for the studies were 1) original research article, 2) cost-effectiveness, 3) comparing pharmacoeconomics with QALY's result, and 4) the limitation is from the past 5 years. Results: A total of 12 studies were included from 2018-2022. The concern of the studies is in telestroke and stroke care which come from 5 Europian, 2 Americas, and 5 Pacific Area. The mean QHES scale score was 80 ± 100. All of the studies were published in English. Conclusion: Cost-saving the result is based on the time horizon, the base year for costing, the QALY Threshold, and the discount rate used by the authors themselves. The nationality and income country will take a few values to impact the result of studies.