Stryker partners with clinical experts on stroke study revealing health budget impact

MedTech & Diagnostics News: Stroke is a leading cause of mortality and disability in Australia, often resulting in poor patient outcomes and significant healthcare costs. Acute ischaemic strokes (AIS), which make up 80-85% of all strokes, are caused by blood clots blocking arteries in the brain. Early restoration of blood flow is crucial for improving outcomes in AIS patients.

A newly published Australian study, led by Associate Professor Laetitia de Villiers, an Interventional Neuroradiologist at Gold Coast University Hospital and funded by Stryker, evaluated the health budget impact of treating AIS using a combination of mechanical thrombectomy (MT) with stent retrievers (SR) and intravenous tissue-plasminogen activator (IV-tPA).

Mechanical thrombectomy has proven both clinically and economically effective for treating AIS with large vessel occlusion (LVO). The clinical superiority of SR MT over IV-tPA thrombolysis alone has been demonstrated in multiple international randomized controlled trials. Treatment with MT significantly improves survival rates, reducing mortality risk by 17% at 90 days. It also enhances functional outcomes and increases the chance of functional independence at 90 days.

Despite its clinical efficacy, timely access to MT in Australia is limited due to geographical challenges and health system fragmentation. The procedure requires a specialised workforce and is performed in a limited number of hospitals because of its complexity and associated risks.

An Australian cost-effectiveness analysis revealed that MT has higher treatment costs compared to IV-tPA alone ($10,666 per patient), but these costs are offset by savings from improved patient outcomes. The analysis indicated both short- and long-term cost benefits, including a lifetime saving of $8,000 per patient for those treated with MT.

While cost-effectiveness analysis measures the value for money of a particular intervention, a budget impact analysis assesses the potential economic impact of adopting a new intervention or modifying existing treatments.

The study found that MT+IV-tPA had a greater budgetary impact than IV-tPA alone, with annual savings beginning in year 1 and continuing through year 5. Cost savings of 21%, or approximately $36 million, could be achieved over five years. Each MT procedure delivers around $3,280 in annual health system savings per patient. Importantly, the study excluded indirect societal impacts, such as increased workforce participation and reduced dependency on family and support services.

“Treatment of AIS with a combination of MT+IV-tPA generates significant savings in the Australian healthcare system compared with IV-tPA alone,” concluded A/Professor de Villiers in the study findings.

Improving access to MT involves overcoming complex, inter-related barriers at individual, service, and system levels. Addressing these challenges requires careful planning and investment in service expansion, delivery models, and streamlined patient pathways across the healthcare system.

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