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New blood clot removal device proven cost-effective

Brown analysis of related health costs demonstrates economic viability of stroke treatment

When used with medication, a new stroke treatment cost $23,203 less than treatment with medication alone, according to a new study by University researchers. The new treatment, thrombectomy — a procedure in which a surgeon widens the artery using a “stent retriever” and then draws out the blood clot — was established as cost-effective in a study conducted by a team co-led by Theresa Shireman, professor of health services, policy and practice.

Strokes, which are often caused by a blood clot in the brain, can have debilitating effects, such as slurred speech and partial paralysis. Doctors must necessarily remove the clot quickly after the stroke occurs, Shireman said. Previously, drugs alone had been used to break apart the clots. But with the advent of thrombectomies, the study co-led by Shireman evaluates a combination of both methods of treatment.

While this procedure had been proven medically effective during a clinical trial run in 2015, the study conducted by Shireman and her team revealed that the treatment is also cost-effective.

In order to assess the financial toll of each treatment, Shireman and her team collected data on the costs of treatment while in the hospital 30 days after the treatment and 90 days after the treatment.

To calculate the costs of the treatment beyond 90 days and complete the study within a reasonable time frame, the authors used a separate group of stroke patients, all of whom were demographically consistent with the group used for the analysis up to 90 days, said Jeffrey Saver, a co-author of the paper and professor of clinical neurology at the University of California at Los Angeles. To analyze the costs after 90 days, the researchers considered factors such as life expectancy, medical costs and daily living expenses. Data were drawn from a variety of national databases to project future costs for patients like those in the study.

While cost-effective analyses vary case by case, the procedure followed in this study is relatively standard for calculating cost predictions, as the data collected was combined with a long-term model, said Milton Weinstein, professor of health policy and management at Harvard. Not all devices that pass clinical trials are evaluated in a cost-effective analysis like this one, which provides evidence to hospitals and insurance companies that the treatment is economically viable. Though the study was funded by Medtronic — the company that produces the device — the researchers secured academic freedom before pursuing the analysis, Shireman said.

Saver considers the outcomes of both the clinical trial and cost-effective analysis to be promising. The study proved that the combined treatment is one that not only improves outcomes for patients but also saves the health system money, Saver said, adding that the results were “very gratifying.”

Shireman furthered that sentiment: “It was really an exciting project to work on. … It’s a project that, at the end of the day, you feel good having been involved in.”


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