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. 2023 Jun;31(6):254-259.
doi: 10.1007/s12471-023-01788-x. Epub 2023 May 12.

Budget impact of endovascular treatment for acute ischaemic stroke patients in the Netherlands for 2015-2021

Lucie A van den Berg  1   2   3   4   5   6 , Olvert A Berkhemer  7   8   9   10   11 , Puck S S Fransen  12 , Debbie Beumer  13   14 , Charles B L Majoie  7   8   9   10   11 , Diederik W J Dippel  12 , Aad van der Lugt  15 , Robert J van Oostenbrugge  13   14 , Wim H van Zwam  16   14 , Yvo B Roos  17   18   7   8   9   10 , Marcel G W Dijkgraaf  18 ; MR CLEAN investigators
Affiliations

Budget impact of endovascular treatment for acute ischaemic stroke patients in the Netherlands for 2015-2021

Lucie A van den Berg et al. Neth Heart J. 2023 Jun.

Abstract

Introduction: Endovascular treatment (EVT) has been proven to be both effective and cost-effective for patients with acute ischaemic stroke. We investigated the budget impact of large-scale implementation of EVT for acute ischaemic stroke patients in the Netherlands for 2015-2021.

Methods: An analysis was performed from a healthcare perspective as a preplanned substudy of the Multicenter Randomized Clinical trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN). Estimated yearly costs during follow-up after stroke for patients who had or had not been treated with EVT as add-on to usual care were linked to numbers of new patients retrieved from 2 Dutch registries of EVT that started after the last inclusion in MR CLEAN (2014). Aggregated costs and costs per care sector were calculated based on prevalence using a population dynamic tool.

Results: From 2015, the yearly number of new acute ischaemic stroke patients receiving EVT increased almost threefold, from 812 in 2015 to 2,370 in 2021. The introduction of EVT plus usual care resulted in estimated net annual savings that increased from € 2.9 million in 2015 to € 58 million in 2021.

Conclusion: Offering EVT as add-on to usual care for acute ischaemic stroke patients was increasingly cost saving from a national healthcare perspective but affected distinct healthcare sectors differently.

Keywords: Economic Evaluation; Endovascular Procedures; Ischaemic Stroke; Thrombectomy.

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Conflict of interest statement

Erasmus Medical Centre received consulting fees from Stryker for A. van der Lugt. Maastricht University Medical Centre received consulting fees from Stryker and Cerenovus for W.H. van Zwam. C.B.L. Majoie received research grants from CVON/Dutch Heart Foundation, European Commission, Healthcare Evaluation Netherlands, TWIN Foundation and Stryker. C.B.L. Majoie and Y.B. Roos are shareholders of Nicolab, a company that focuses on the use of artificial intelligence for medical image analysis. D.W.J. Dippel and A. van der Lugt received grants from Stryker, Penumbra Inc., Medtronic, Cerenovus, Dutch Heart Foundation, Brain Foundation Netherlands, Netherlands Organisation for Health Research and Development and Thrombolytic Science, all unrestricted and paid to Erasmus Medical Centre. L.A. van den Berg, O.A. Berkhemer, P.S.S. Fransen, D. Beumer, R.J. van Oostenbrugge and M.G.W. Dijkgraaf declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Overall budget impact structure. Budget impact model estimated nationwide impact of endovascular treatment as add-on to usual care on costs of healthcare for eligible acute ischaemic stroke patients (2015–2021). ^ Unknown mean costs for 7th follow-up year of new patients in 2015 have not been included in calendar year 2021
Fig. 2
Fig. 2
Budget impact of endovascular treatment as add-on to usual care (2015–2021)
See this image and copyright information in PMC

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