Article Text
Abstract
Introduction Stroke is a leading cause of death and disability globally, with an estimated European economic burden of €45 billion annually. The MASTRO I meta-analysis found the use of the EmboTrap Revascularization Device during mechanical thrombectomy (MT) resulted in higher rates of good functional outcomes (90-day mRS 0–2) compared to the Trevo Retriever and Solitaire Revascularization Device.
Aim of Study This analysis estimates the cost-consequence of stent retriever (SR) choice based on results reported in MASTRO I.
Methods A cost analysis with a German hospital (short-term) perspective was developed using a decision tree to simulate index hospitalization costs for a cohort of acute ischemic stroke patients achieving mRS 0–2 vs 3–5 treated with EmboTrap, Trevo or Solitaire. Short-term costs were calculated per device based on hospital length of stay by mRS level and reported inpatient cost per day. Patients who died within 90-days of treatment (mRS 6) were excluded. Hospital cost savings were reported.
Results Assuming price parity across all three SRs, total per-patient short-term index hospitalization costs for EmboTrap, Trevo and Solitaire were €12.723, €13.328, €13.482, respectively, resulting in cost savings favoring EmboTrap of €604 vs Trevo and €759 vs Solitaire. Cost savings persisted in sensitivity analysis based on varying premium pricing by 5–10% for EmboTrap.
Conclusion The use of EmboTrap in Germany may lead to reduction in short-term hospital costs, compared to Solitaire or Trevo due to improved patient functional outcomes (90-day mRS 0–2). These findings may inform evidence-based decision making when selecting a cost-efficient SR for MT.
Disclosure of Interest Osama Zaidat reports consulting fees for Stryker, Medtronic, Cerenovus, and Penumbra; research grants from Stryker, Medtronic, Cerenovus, Penumbra, and Genentech; in addition, Dr Zaidat had a patent for ischemic stroke issued.
Tommy Andersson is a consultant for Anaconda, Cerenovus, Neuravi and Rapid Medical, and holds equity in Ceroflo.
Mina Kabiri is an employee of Johnson & Johnson.
Shanti Scheffler is an employee of Johnson & Johnson.
Emilie Kottenmeier is an employee of Johnson & Johnson.