Cost-effectiveness of Analysis Sequential Therapy with Butylphthalide in Treatment of Ischemic Stroke After Reperfusion Based on Markov Model

OBJECTIVE  To evaluate the economic of sequential therapy with butylphthalide for patients with acute ischemic stroke after reperfusion.

METHODS  From the perspective of the health system, based on the results of a randomized controlled clinical trial, Markov model was constructed to simulate the dynamic changes of no significant disability, significant disability, recurrence, and death. The experimental group was treated with reperfusion combined with sequential butylphthalide, while the control group was treated with reperfusion combined with placebo. Utilize TreeAge Pro 2020 software to construct pharmacoeconomic models and conduct simulation analyses.

RESULTS  After 30 cycles of model simulation, the results showed that the cost and output of the experimental group were 294039.09 yuan and 4.86 quality adjusted life years(QALYs); the results showed that the cost and output of the control group were 269042.84 yuan and 4.66 QALYs. Compared with the control group, the incremental cost effectiveness of the experimental group was 126816.55 yuan·QALY⁻¹, which was less than the willingness to pay threshold. The sensitivity analysis supported the robustness of the results.

CONCLUSION  For acute ischemic stroke patients with vascular recanalization, compared to placebo, sequential treatment with butylphthalide is a pharmacoeconomic advantageous treatment.