缺血性脑卒中溶栓配合机械取栓对比单纯溶栓治疗的卫生经济学评价研究

Health Economic Evaluation of Intravenous Thrombolysis with Mechanical Thrombectomy compared with Intravenous Thrombolysis Alone on Treatment of Acute Ischemic Stroke

目的 :基于中国人群临床产出和成本环境,评估溶栓配合机械取栓对比单纯溶栓治疗缺血性脑卒中的经济性。方法 :基于文献资料和临床研究数据,采用决策树和马尔科夫相结合的模型,对溶栓配合机械取栓对比单纯溶栓治疗缺血性脑卒中的经济性进行评价。结果 :与单纯溶栓相比,溶栓配合机械取栓治疗缺血性脑卒中,在治疗后30年间可提高0.78个QALY,总成本增加47237.88元,ICER值为60561.38元/QALY。结论 :在机械取栓产品研究期间的价格水平、诊疗情境和我国人均GDP水平下,相对于单纯溶栓治疗,溶栓配合机械取栓治疗缺血性脑卒中具有卫生经济性。

Objective: To perform the health economic evaluation of intravenous thrombolysis combined with mechanical thrombectomy vs. intravenous thrombolysis alone in the treatment of acute ischemic stroke in China. Methods: Based on literature review and clinical trial data, to evaluate the cost and effectiveness of intravenous thrombolysis combined with mechanical thrombectomy and intravenous thrombolysis alone in the treatment of acute ischemic stroke using the combination of decision tree and Markov model. Results: Compared with intravenous thrombolysis alone, in 30 years after treatment, intravenous thrombolysis combined with mechanical thrombectomy yielded additional 0.78 QALYs, additional cost of 47237.88 RMB, and the ICER was 60561.38 RMB/QALY. Conclusion: Under the current price of thrombectomy devices, treatment situation and Chinese GDP per capita, compared with thrombolytic therapy alone, thrombolytic therapy combined with mechanical thrombectomy is a cost-eff ective alternative in the treatment of acute ischemic stroke patients in China.