Benefit from expert advice on the economic realities of #STROKE treatment

Nowadays, healthcare decisions cannot be made without taking economics into consideration. In the past, a simple and clear scientific demonstration of a given therapy’s clinical superiority was enough to influence an entire health organization’s way of getting better care to patients. Today, however, we are coming to terms with the hard truth that healthcare budgets come in limited envelopes that need to cover not only current therapeutic options, but also innovation.


In the current medical landscape, we are witnessing exponential growth of cutting-edge therapies from the fields of immunotherapy, oncology, robotic surgery and, of course, minimally-invasive endovascular therapy, all of which are competing for the same restricted allocated healthcare budget. Consequently, healthcare decisions cannot be solely driven by the added clinical benefit for the patient but must also be made in-line with cost-effective analyses that ensure that a chosen therapy results in an overall financial balance that makes room for continuous innovation.


Stroke care innovation – thrombectomy in particular – is a perfect example of this pragmatic approach. Despite the widespread demonstration of its clinical benefit since 2014, its adoption rate tends to be growing very slowly in most countries. The underlying reason behind this appears to be a lack of visibility with regard to the cost-effectiveness of this new treatment. Developing a comprehensive, country-specific health-economic model that allows local and national authorities to measure the potential benefit of thrombectomy is, today, a key means for justifying and quantifying the acquisition of new resources and new equipment that could be allocated to this stroke therapy in a given country. While an early-on analysis (Lobotesis et al, Stroke, 2015) demonstrated an immensely positive cost-effective benefit, it isn’t possible to replicate it and sufficiently determine and quantify the therapeutic effects in other countries where rehabilitation costs may differ dramatically.


It’s inspiring to see that the choice to adopt new therapies no longer lies solely in the hands of medical experts, but is now being tackled by a comprehensive multidisciplinary team of healthcare engineers, doctors and epidemiologists who, on a case-by-case basis, examine the added value of each innovation for a specific healthcare system. Both within our field and outside of it, we are competing against other therapy innovations that may also bring an added clinical benefit to various patient groups. It’s up to us to demonstrate the added value of our services for the greater population. While this may seem to be a daunting new job for us, it’s critical for spreading and improving stroke care on a larger scale.


Pr. Vincent COSTALAT
CHU de Montpellier


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