Data from: Public health and cost consequences of time delays to thrombectomy for acute ischemic stroke

Objective: To determine public health and cost consequences of time delays
to EVT for patients, healthcare systems, and society, we estimated
quality-adjusted life years (QALY) of EVT-treated patients and associated
costs based on times to treatment. Methods: The Markov model analysis was
performed from United States healthcare and societal perspectives over a
lifetime horizon. Contemporary data from seven trials within the HERMES
collaboration served as data source. Aside from cumulative lifetime costs,
we calculated the net monetary benefit (NMB) to determine the economic
value of care. We used a contemporary willingness-to-pay threshold of
$100,000 per QALY for NMB calculations. Results: Every 10 minutes of
earlier treatment resulted in an average gain of 39 days (95% prediction
interval: 23-53 days) of disability-free life. Overall, the cumulative
lifetime costs for patients with earlier or later treatment were similar.
Patients with later treatment had higher morbidity-related costs yet over
a shorter time span due to their shorter life expectancy, resulting in
similar lifetime costs as in patients with early treatment. Regarding the
economic value of care, every 10 minutes of earlier treatment increased
the NMB by $10,593 (95% prediction interval: $5,549-$14,847) and by
$10,915 (95% prediction interval: $5,928-$15,356) taking healthcare and
societal perspectives, respectively. Conclusions: Any time delay to EVT
reduces QALYs and decreases the economic value of care provided by this
intervention. Healthcare policies to implement efficient pre-hospital
triage and accelerate in-hospital workflow are urgently needed.