Tenecteplase in managing acute ischemic stroke: a long-term cost-utility analysis in Iran.
Acute ischemic stroke
alteplase
cost-effectiveness analysis
cost–utility analysis
tenecteplase
Journal
Expert review of pharmacoeconomics & outcomes research
ISSN: 1744-8379
Titre abrégé: Expert Rev Pharmacoecon Outcomes Res
Pays: England
ID NLM: 101132257
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
pubmed:
25
11
2022
medline:
17
1
2023
entrez:
24
11
2022
Statut:
ppublish
Résumé
The advantage of tenecteplase (TNK) over alteplase (ALT) in managing acute ischemic stroke (AIS) has been reported, but the cost-effectiveness of these two strategies has not received as much attention. The objective of this study was to compare TNK and ALT for the management of AIS patients in Iran in terms of cost-effectiveness. This study was carried out from the payer's perspective in Iran, with a lifetime horizon. A full economic evaluation model was designed as a decision tree and a Markov model. After defining different Markov states, each health state was assigned a utility value, and quality-adjusted life year (QALY) was estimated using that value. The incremental cost-effectiveness ratio (ICER) was ultimately used for evaluating the comparative cost-effectiveness. Both deterministic and probabilistic sensitivity analyses were carried out. Compared to ALT, TNK can save approximately 4333.81 USD, and is able to increase one unit of QALY while saving approximately 17,450.29 USD. So, Base-case results showed that TNK strongly dominates ALT. Moreover, the base case results were strongly confirmed by deterministic and probabilistic sensitivity analysis. Base-case and sensitivity analysis showed that TNK is the dominant strategy compared to ALT for the management of AIS patients.
Sections du résumé
BACKGROUND & AIMS
UNASSIGNED
The advantage of tenecteplase (TNK) over alteplase (ALT) in managing acute ischemic stroke (AIS) has been reported, but the cost-effectiveness of these two strategies has not received as much attention. The objective of this study was to compare TNK and ALT for the management of AIS patients in Iran in terms of cost-effectiveness.
METHODS
UNASSIGNED
This study was carried out from the payer's perspective in Iran, with a lifetime horizon. A full economic evaluation model was designed as a decision tree and a Markov model. After defining different Markov states, each health state was assigned a utility value, and quality-adjusted life year (QALY) was estimated using that value. The incremental cost-effectiveness ratio (ICER) was ultimately used for evaluating the comparative cost-effectiveness. Both deterministic and probabilistic sensitivity analyses were carried out.
RESULTS
UNASSIGNED
Compared to ALT, TNK can save approximately 4333.81 USD, and is able to increase one unit of QALY while saving approximately 17,450.29 USD. So, Base-case results showed that TNK strongly dominates ALT. Moreover, the base case results were strongly confirmed by deterministic and probabilistic sensitivity analysis.
CONCLUSIONS
UNASSIGNED
Base-case and sensitivity analysis showed that TNK is the dominant strategy compared to ALT for the management of AIS patients.
Identifiants
pubmed: 36420792
doi: 10.1080/14737167.2023.2152008
doi:
Substances chimiques
Tenecteplase
WGD229O42W
Tissue Plasminogen Activator
EC 3.4.21.68
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM