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DC Field | Value | Language |
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dc.contributor.author | Gao, Lan | - |
dc.contributor.author | Moodie, Marj | - |
dc.contributor.author | Mitchell, Peter J. | - |
dc.contributor.author | Churilov, Leonid | - |
dc.contributor.author | Kleinig, Timothy J. | - |
dc.contributor.author | Yassi, Nawaf | - |
dc.contributor.author | Yan, Bernard | - |
dc.contributor.author | Parsons, Mark W. | - |
dc.contributor.author | Donnan, Geoffrey A. | - |
dc.contributor.author | Davis, Stephen M. | - |
dc.contributor.author | Campbell, Bruce C. V. | - |
dc.contributor.author | EXTEND-IA TNK Investigators | - |
dc.date.accessioned | 2023-04-24T02:44:19Z | - |
dc.date.available | 2023-04-24T02:44:19Z | - |
dc.date.issued | 2020 | - |
dc.identifier.uri | https://repository.southwesthealthcare.com.au/swhealthcarejspui/handle/1/3844 | - |
dc.description.abstract | BACKGROUND AND PURPOSE: Tenecteplase improved functional outcomes and reduced the requirement for endovascular thrombectomy in ischemic stroke patients with large vessel occlusion in the EXTEND-IA TNK randomized trial. We assessed the cost-effectiveness of tenecteplase versus alteplase in this trial. METHODS: Post hoc within-trial economic analysis included costs of index emergency department and inpatient stroke hospitalization, rehabilitation/subacute care, and rehospitalization due to stroke within 90 days. Sources for cost included key study site complemented by published literature and government websites. Quality-adjusted life-years were estimated using utility scores derived from the modified Rankin Scale score at 90 days. Long-term modeled cost-effectiveness analysis used a Markov model with 7 health states corresponding to 7 modified Rankin Scale scores. Probabilistic sensitivity analyses were performed. RESULTS: Within the 202 patients in the randomized controlled trial, total cost was nonsignificantly lower in the tenecteplase-treated patients (40 997 Australian dollars [AUD]) compared with alteplase-treated patients (46 188 AUD) for the first 90 days(P=0.125). Tenecteplase was the dominant treatment strategy in the short term, with similar cost (5412 AUD [95% CI, -13 348 to 2523]; P=0.181) and higher benefits (0.099 quality-adjusted life-years [95% CI, 0.001-0.1967]; P=0.048), with a 97.4% probability of being cost-effective. In the long-term, tenecteplase was associated with less additional lifetime cost (96 357 versus 106 304 AUD) and greater benefits (quality-adjusted life-years, 7.77 versus 6.48), and had a 100% probability of being cost-effective. Both deterministic sensitivity analysis and probabilistic sensitivity analyses yielded similar results. CONCLUSIONS: Both within-trial and long-term economic analyses showed that tenecteplase was highly likely to be cost-effective for patients with acute stroke before thrombectomy. Recommending the use of tenecteplase over alteplase could lead to a cost saving to the healthcare system both in the short and long term. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02388061. | - |
dc.relation.isversionof | 20201007 | - |
dc.subject | Combined Modality Therapy | - |
dc.subject | Cost-Benefit Analysis | - |
dc.subject | Emergency Service | - |
dc.subject | Endovascular Procedures | - |
dc.subject | Fibrinolytic Agents | - |
dc.subject | Hospitalization | - |
dc.subject | Humans | - |
dc.subject | Ischemic Stroke | - |
dc.subject | Markov Chains | - |
dc.subject | Mortality | - |
dc.subject | Patient Readmission | - |
dc.subject | Quality-Adjusted Life Years | - |
dc.subject | Randomized Controlled Trials as Topic | - |
dc.subject | Recurrence | - |
dc.subject | Stroke Rehabilitation | - |
dc.subject | Tenecteplase | - |
dc.subject | Thrombectomy | - |
dc.subject | Tissue Plasminogen Activator | - |
dc.subject | United States | - |
dc.subject | Infarction | - |
dc.subject | Stroke | - |
dc.subject | Tenecteplase | - |
dc.subject | Thrombectomy | - |
dc.title | Cost-Effectiveness of Tenecteplase Before Thrombectomy for Ischemic Stroke | - |
dc.type | Journal Article | - |
dc.identifier.journaltitle | Stroke | - |
dc.accession.number | 33023423 | - |
dc.identifier.url | https://www.ncbi.nlm.nih.gov/pubmed/33023423 | - |
dc.description.affiliation | Deakin Health Economics, Institute of Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia (L.G., M.M.). | - |
dc.description.affiliation | Department of Radiology, Royal Melbourne Hospital (P.J.M.), University of Melbourne, Parkville, Australia. | - |
dc.description.affiliation | Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital (L.C., N.Y., B.Y., M.W.P., G.A.D., S.M.D., B.C.V.C.), University of Melbourne, Parkville, Australia. | - |
dc.description.affiliation | Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Australia (L.C.). | - |
dc.description.affiliation | Department of Neurology, Royal Adelaide Hospital, South Australia, Australia (T.J.K.). | - |
dc.description.affiliation | Florey Institute of Neuroscience and Mental Health (N.Y., B.C.V.C.), University of Melbourne, Parkville, Australia. | - |
dc.description.affiliation | Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia (N.Y.). | - |
dc.format.startpage | 3681-3689 | - |
dc.source.volume | 51 | - |
local.issue.number | 12 | - |
dc.identifier.notes | eng | - |
dc.identifier.notes | 2020/10/08 | - |
dc.identifier.notes | Stroke. 2020 Dec;51(12):3681-3689. doi: 10.1161/STROKEAHA.120.029666. Epub 2020 Oct 7. | - |
dc.identifier.importdoi | 10.1161/STROKEAHA.120.029666 | - |
dc.identifier.date | Dec | - |
dc.identifier.date | 2020 | - |
Appears in Collections: | SWH Data Contributions |
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