Cost-benefit analysis of stroke rehabilitation in Iran

ABSTRACT

Background

The economic evaluation of medication interventions for stroke has been the subject of much economic research. This study aimed to examine the cost-benefit of multidisciplinary rehabilitation services for stroke survivors in Iran.

Methods

This economic evaluation was conducted from the payer’s perspective with a lifetime horizon in Iran. A Markov model was designed and Quality-adjusted life years (QALYs) were the final outcomes. First, to evaluate the cost-effectiveness, the incremental cost-effectiveness ratio (ICER) was calculated. Then, using the average net monetary benefit (NMB) of rehabilitation, the average Incremental Net Monetary Benefit (INMB) per patient was calculated. The analyses were carried out separately for public and private sector tariffs.

Results

While considering public tariffs, the rehabilitation strategy had lower costs (US$5320 vs. US$ 6047) and higher QALYs (2.78 vs. 2.61) compared to non-rehabilitation. Regarding the private tariffs, the rehabilitation strategy had slightly higher costs (US$6,698 vs. US$6,182) but higher QALYs (2.78 vs. 2.61) compared to no rehabilitation. The average INMB of rehabilitation vs non-rehabilitation for each patient was estimated at US$1518 and US$275 based on Public and private tariffs, respectively.

Conclusion

Providing multidisciplinary rehabilitation services to stroke patients was cost-effective and has positive INMBs in public and private tariffs.

KEYWORDS:

• Cost-benefit
• Economic evaluation
• Rehabilitation
• Stroke
• Cost

Declaration of interest

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.

Author contributions

Conception and design: R Daroudi, A Darvishi, M Mousavi, M Shirazikhah. Analysis and interpretation of the data: A Darvishi, M Mousavi, M Shirazikhah, M Alizadeh Zarei, H Hendi, F Joghataei. Drafting of the paper: R Abdi Dezfouli. Revising the paper critically: A Darvishi, M Mousavi, M Shirazikhah, M Alizadeh Zarei, H Hendi, F Joghataei. All authors approved the final version of the manuscript to be published.

Additional information

Funding

This research was funded by the Rehabilitation Consultant Office of the Iran’s Ministry of Health, Treatment and Medical Education and the University of Rehabilitation Sciences and Social Health.