Budgetary impact analysis of alteplase - recombinant tissue plasminogen activator (rtPA) - as a thrombolytic treatment for acute ischemic stroke in Colombia

ABSTRACT

Introduction

Thrombolysis is effective for treating acute ischemic stroke (AIS). Trials have evaluated its effectiveness at different timepoints after stroke. The objective of the study was to evaluate the clinical and budgetary impact of increasing the proportion of thrombolyzed acute ischemic stroke patients in Colombia. 

Methods

The budgetary impact was estimated for a 5-year time horizon from the perspective of the third-party payer. Costs were estimated using local standardized methods and expressed in US dollars of 2020. We compared two scenarios: a current one and an alternative one, with doubled thrombolysis access

Results

The increase in thrombolyzed patients would decrease the number of patients with sequelae by 1,721, 2,594 and 1,007 in the ranges of 0–90 minutes, 91–180 and 181–270, respectively. The budget effort increase for each of the treatment initiation ranges is of USD$15,525,649(+5.5%), USD$16,665,304(+5.7%) and USD$16,963,231(+7.0%), respectively. 

Conclusions

Doubling the number of patients with AIS who are thrombolyzed would lead to reductions in the number of patients with sequelae and would require a budgetary effort of 5.5–7.0%. The early initiation of treatment gives an additional benefit in reducing the number of sequelae and a lower budgetary impact than initiation within the later time window. 

KEYWORDS:

• Alteplase
• budgetary impact
• Colombia
• ischemic stroke
• thrombolysis

Author contributions

Y Gil-Rojas and P Lasalvia were responsible for the literature review, cost estimation, data analysis, as well as the conception and final revision of the manuscript. All authors agree for the final version of the manuscript to be published.

Declaration of interest

Y Gil-Rojas and P Lasalvia report grants from Boehringer, during the conduct of the study. Y Gil-Rojas and P Lasalvia were employed by NeuroEconomix. NeuroEconomix received funding from Boehringer Ingelheim Colombia for this project. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2022.2089655

Additional information

Funding

This study was funded by Boehringer Ingelheim S.A. Colombia.