Tristan D Gloede1, Sarah M Halbach1, Amanda G Thrift1, Helen M Dewey1, Holger Pfaff1, Dominique A Cadilhac2. 1. From the Institute for Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany (T.D.G., S.M.H., H.P.); Stroke and Ageing Research, School of Clinical Sciences, Monash University Clayton, Victoria, Australia (A.G.T., D.A.C.); Stroke Division, the Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (A.G.T., H.M.D., D.A.C.); Department of Medicine, University of Melbourne, Parkville, Victoria, Australia (H.M.D., D.A.C.); Department of Neurology, Austin Health, Melbourne, Australia (H.M.D.); and Deakin Health Economics, Deakin University, Victoria, Australia (D.A.C.). 2. From the Institute for Medical Sociology, Health Services Research and Rehabilitation Science, University of Cologne, Cologne, Germany (T.D.G., S.M.H., H.P.); Stroke and Ageing Research, School of Clinical Sciences, Monash University Clayton, Victoria, Australia (A.G.T., D.A.C.); Stroke Division, the Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (A.G.T., H.M.D., D.A.C.); Department of Medicine, University of Melbourne, Parkville, Victoria, Australia (H.M.D., D.A.C.); Department of Neurology, Austin Health, Melbourne, Australia (H.M.D.); and Deakin Health Economics, Deakin University, Victoria, Australia (D.A.C.). dominique.cadilhac@monash.edu.
Abstract
BACKGROUND AND PURPOSE: Stroke is costly, although little is known about the long-term costs of survivors of stroke. In previous cost-of-illness studies, lifetime costs have been modeled based on estimates to 5 years after stroke. Building on previous work from the North East Melbourne Stroke Incidence Study (NEMESIS), we aimed to describe resource use at 10 years and recalculate the lifetime societal costs of ischemic and hemorrhagic (intracerebral hemorrhage) stroke. METHODS: Ten-year patient-level resource use data were obtained and updated prices and population demographic statistics for 2010 were applied to our cost-of-illness models. We incorporated incidence data from a larger study region of NEMESIS than that used in the previous model and new 10-year survival and recurrent stroke rates. One-way sensitivity and probabilistic multivariable uncertainty analyses were undertaken. RESULTS: For ischemic stroke, the overall average annual direct costs at 10 years (US dollars [USD] 5207) were comparable to those for survivors between 3 and 5 years (USD5438). However, the contribution of some costs varied (eg, medications contributed 13% at 5 years and 20% at 10 years). For intracerebral hemorrhage, annual direct costs were considerably (24%) greater at 10 years than estimated using 3 to 5 year data. Greater average lifetime costs per case were found using the updated models (ischemic stroke: previous model USD51806 and current USD68 769; intracerebral hemorrhage: previous model USD43 786 and current USD54 956 per case). Following sensitivity and multivariable uncertainty analyses, the findings were robust. CONCLUSIONS: Costs to 10 years after stroke have not previously been reported. Our findings demonstrate the importance of estimating resource use over longer periods for forecasting lifetime estimates.
BACKGROUND AND PURPOSE:Stroke is costly, although little is known about the long-term costs of survivors of stroke. In previous cost-of-illness studies, lifetime costs have been modeled based on estimates to 5 years after stroke. Building on previous work from the North East Melbourne Stroke Incidence Study (NEMESIS), we aimed to describe resource use at 10 years and recalculate the lifetime societal costs of ischemic and hemorrhagic (intracerebral hemorrhage) stroke. METHODS: Ten-year patient-level resource use data were obtained and updated prices and population demographic statistics for 2010 were applied to our cost-of-illness models. We incorporated incidence data from a larger study region of NEMESIS than that used in the previous model and new 10-year survival and recurrent stroke rates. One-way sensitivity and probabilistic multivariable uncertainty analyses were undertaken. RESULTS: For ischemic stroke, the overall average annual direct costs at 10 years (US dollars [USD] 5207) were comparable to those for survivors between 3 and 5 years (USD5438). However, the contribution of some costs varied (eg, medications contributed 13% at 5 years and 20% at 10 years). For intracerebral hemorrhage, annual direct costs were considerably (24%) greater at 10 years than estimated using 3 to 5 year data. Greater average lifetime costs per case were found using the updated models (ischemic stroke: previous model USD51806 and current USD68 769; intracerebral hemorrhage: previous model USD43 786 and current USD54 956 per case). Following sensitivity and multivariable uncertainty analyses, the findings were robust. CONCLUSIONS: Costs to 10 years after stroke have not previously been reported. Our findings demonstrate the importance of estimating resource use over longer periods for forecasting lifetime estimates.
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Authors: N E Andrew; J Kim; D A Cadilhac; V Sundararajan; A G Thrift; L Churilov; N A Lannin; M Nelson; V Srikanth; M F Kilkenny Journal: Int J Popul Data Sci Date: 2019-08-05
Authors: Ana Beatriz Ayroza Galvão Ribeiro Gomes; Mauro Henrique; Vinicius Andreoli Schoeps; Mariana Monteiro Saldanha Altenfelder Santos; Ada Pellegrinelli; Bárbara Pessoa de Matos; Gabriel Taricani Kubota; Haniel Alves Araújo; Letícia Sant' Ana Cardoso da Silva; Fabrício de Paula Leite Battisti; Bruno Yukio Kubota; Areta Cavalcanti Ferreira; Mateus Paquesse Pellegrino; Renata de Andrade Prado; Ronaldo Abrahm; Vivian Dias Baptista Gagliardi; Marcel Simis; Rubens José Gagliardi Journal: eNeurologicalSci Date: 2016-12-16