Leader: Universitätsklinikum Hamburg-Eppendorf  – Judith Dams

WP6 will perform an economic evaluation of the tested interventions and assess the costs and cost-effectiveness of the tested interventions as well as possible gender effects. Main objectives are:

• Assess the costs of both treatment arms (thrombectomy, best medical treatment)
• Assess cost-effectiveness of the tested intervention (thrombectomy)
• Analysis of gender effects in treatment and outcome
• Provide economic evaluation for individual countries and on a European level

This WP will perform a comprehensive economic evaluation of the tested intervention (thrombectomy) as compared to best medical treatment for the population enrolled in the trial (i.e. severe strokes with extended stroke lesions in an extended time window). This will include both the direct and indirect, monetary and non-monetary, costs and benefits of treatment. Important subtasks include the identification of the categories of costs and benefits, valuing changes in relevant units (monetary units or quality adjusted life years), and estimating the average cost-effectiveness ratios in a model which takes into account the stochastic nature of major events for these patients. Treatment benefit will be expressed in terms of the number of quality-adjusted life years gained, and the cost per QALY gained will be estimated to inform decisions according to the principles of value-based health-care. Indirect financial consequences, e.g. in terms of cost savings by avoiding expensive care in long-term nursing facilities, will also be assessed. In order to estimate both the gain in terms of QALYs and the monetary cost reductions, we will use a Markov model. In this model each patient is assumed to be in a certain state, and for each time period there is a certain probability that the patient will go from one state to another. We will simulate the flow of patients between the different states and use this to estimate the average number of years patients will gain.

Hospices Civil de Lyon will support statistical analysis in WP6.