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Cost-effectiveness of endovascular therapy for acute stroke with a large ischemic region in Japan: impact of the Alberta Stroke Program Early CT Score on cost-effectiveness
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  • Published on: 19 December 2023
    Cost-effectiveness of Endovascular treatment for Acute Ischemic Stroke in Japan
    • Amirhossein Kamalinia, Resident Physician Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran

    Dear Editor,
    I am writing to provide a thorough assessment of the recently published study titled "Cost-effectiveness of Endovascular Therapy for Acute Stroke with a Large Ischemic Region in Japan: Impact of the Alberta Stroke Program Early CT Score on Cost-effectiveness" [1]. While the study addresses important aspects of the economic implications of endovascular therapy (EVT) for acute ischemic stroke (AIS) in Japan, my analysis aims to delve deeper into specific methodological considerations and discuss the applicability of the study's findings in a broader context.
    The primary focus of the study is the cost-effectiveness of EVT based on the Alberta Stroke Program Early CT Score (ASPECTS) for patients with AIS involving a large ischemic region. The conclusion that EVT is cost-effective for individuals with ASPECTS of 3–5 as determined by treating neurologists using MRI raises questions about the reliability and consistency of ASPECTS as a determinant of cost-effectiveness. Furthermore, the study acknowledges the variability in incremental costs and quality-adjusted life years (QALYs) associated with EVT in Japan compared to other countries. The higher incremental costs in Japan, attributed to the specific stroke care system and the frequent use of combined techniques and MRI, present challenges when applying these findings to healthcare systems with different cost structures and resource allocations.
    The study acknowledges the variabilit...

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    Conflict of Interest:
    None declared.