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New Stroke Drug Saves Money While Reducing Disability
ST. PAUL, MN (April 22, 1998) - Stroke patients treated with the new stroke drug tissue plasminogen activator (t-PA) generally have better outcomes and therefore are less costly to the health care system than those not treated, according to an article published in the April issue of Neurology, the scientific journal of the American Academy of Neurology.
The administration of this drug results in more patients who are able to go home, rather than to expensive rehabilitation or long-term care facilities, according to study author, Susan Fagan, Pharm. D., associate professor at Wayne State University in Detroit, MI.
"Forty-eight percent of patients who were treated with t-PA went home, while 36 percent of the placebo patients did so. The remainder of the patients were admitted to some type of rehabilitation or long-term care facility," Fagan said.
The authors estimated total cost reductions of t-PA usage to be $1.7 million in hospitalization costs, $1.4 million in rehabilitation costs and $4.8 million in long-term care per 1,000 treated patients. In addition, as a result of decreased disability with t-PA therapy, long-term improvements in patients' quality of life can be expected. Use of t-PA also resulted in shorter hospital stays -- 10.9 days vs. 12.4 days.
In their evaluation, the authors included the drug cost (about $2,300 per 100 mg vial) and the additional costs of a specialists -- neurologist or emergency physician -- to evaluate and administer the drug. The drug must be given within three hours after the start of symptoms.
The authors based their conclusions on a model that examined treatment costs per 1,000 patients eligible for t-PA treatment, and compared the costs to untreated patients. Using data from the National Institute of Neurological Disorders and Stroke (NINDS) t-PA Stroke Trial and medical literature, the authors estimated the health and economic outcomes associated with using t-PA in acute stroke patients. The research was funded by NINDS. The NINDS trial led to the approval of t-PA for use in stroke.
Fagan estimates that hospitals that use the drug are treating only one or two patients with t-PA per month. "We think the therapy is underutilized -- the main reason being that patients don't come in early enough," she said. "More public education is needed to improve the recognition and response to stroke symptoms."
The American Academy of Neurology is conducting a stroke awareness public education effort, as are the American Heart Association and the National Stroke Association. The AAN's efforts include a public service announcement, a video news release and an extensive constituency relations effort that includes five task forces designed to reach women, workplaces, health care providers, diversity groups and the elderly. The AAN is also coordinating a professional education effort that involves regional acute stroke management workshops.
The American Academy of Neurology, an association of more than 15,000 neurologists and neuroscience professionals, is celebrating its 50th year of improving care for stroke patients and others with neurological disorders through education and research.
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