Results from a new study show a greater than 90 percent probability that treating acute ischemic stroke patients with the clot-busting drug t-PA could result in a substantial net cost savings to the health care system. These savings are based on the fact that t-PA-treated stroke patients leave the hospital sooner and require less rehabilitation and nursing after discharge than do patients who do not receive t-PA. The study also showed that t-PA-treated stroke patients, because of their decreased disability, can expect to have an improved quality of life. These results, published in the April 1998 issue of Neurology, were reported by Susan Fagan, Pharm. D., Associate Professor of Pharmacy Practice at Wayne State University and Henry Ford Hospital. This study was sponsored by the National Institute of Neurological Disorders and Stroke (NINDS). (1)
Dr. Fagan estimated the costs per 1,000 patients eligible for treatment with t-PA compared with the costs per 1,000 stroke patients not treated with t-PA. The study used data from the NINDS t-PA Stroke Trial,(2) in which the average length of a hospital stay was shorter in t-PA-treated patients, 10.9 days, than in patients not treated with t-PA, 12.4 days. t-PA-treated patients were more frequently discharged to their home than to inpatient rehabilitation centers or nursing homes.
The cost of t-PA treatment increases hospital costs for patients when they are first admitted. However, because t-PA shortens hospital stays and decreases long-term disabilities, there is a net savings. For 1,000 t-PA patients, the researchers estimate an initial increase in hospital costs of $1.7 million, but an eventual savings of $4.8 million in nursing home care costs and $1.3 million in rehabilitation costs. The overall impact is a net decrease of more than $4 million in health care costs for every 1,000 patients treated.
"Considering that there are tens of thousands of stroke p
Contact: Margo Warren or Marian Emr
NIH/National Institute of Neurological Disorders and Stroke