TY - JOUR
T1 - Long-term costs of stroke using 10-year longitudinal data from the North East Melbourne Stroke Incidence Study
AU - Gloede, Tristan D
AU - Halbach, Sarah M
AU - Thrift, Amanda Gay
AU - Dewey, Helen M
AU - Pfaff, Holger
AU - Cadilhac, Dominique Ann-Michelle
PY - 2014
Y1 - 2014
N2 - Background and Purpose?Stroke is costly, although little is known about the long-term costs of survivors of stroke. In
previous cost-of-illness studies, lifetime costs have been modeled based on estimates to 5 years after stroke. Building on
previous work from the North East Melbourne Stroke Incidence Study (NEMESIS), we aimed to describe resource use
at 10 years and recalculate the lifetime societal costs of ischemic and hemorrhagic (intracerebral hemorrhage) stroke.
Methods?Ten-year patient-level resource use data were obtained and updated prices and population demographic statistics
for 2010 were applied to our cost-of-illness models. We incorporated incidence data from a larger study region of
NEMESIS than that used in the previous model and new 10-year survival and recurrent stroke rates. One-way sensitivity
and probabilistic multivariable uncertainty analyses were undertaken.
Results?For ischemic stroke, the overall average annual direct costs at 10 years (US dollars [USD] 5207) were comparable
to those for survivors between 3 and 5 years (USD5438). However, the contribution of some costs varied (eg, medications
contributed 13 at 5 years and 20 at 10 years). For intracerebral hemorrhage, annual direct costs were considerably
(24 ) greater at 10 years than estimated using 3 to 5 year data. Greater average lifetime costs per case were found using
the updated models (ischemic stroke: previous model USD51806 and current USD68 769; intracerebral hemorrhage:
previous model USD43 786 and current USD54 956 per case). Following sensitivity and multivariable uncertainty
analyses, the findings were robust.
Conclusions?Costs to 10 years after stroke have not previously been reported. Our findings demonstrate the importance of
estimating resource use over longer periods for forecasting lifetime estimates.
AB - Background and Purpose?Stroke is costly, although little is known about the long-term costs of survivors of stroke. In
previous cost-of-illness studies, lifetime costs have been modeled based on estimates to 5 years after stroke. Building on
previous work from the North East Melbourne Stroke Incidence Study (NEMESIS), we aimed to describe resource use
at 10 years and recalculate the lifetime societal costs of ischemic and hemorrhagic (intracerebral hemorrhage) stroke.
Methods?Ten-year patient-level resource use data were obtained and updated prices and population demographic statistics
for 2010 were applied to our cost-of-illness models. We incorporated incidence data from a larger study region of
NEMESIS than that used in the previous model and new 10-year survival and recurrent stroke rates. One-way sensitivity
and probabilistic multivariable uncertainty analyses were undertaken.
Results?For ischemic stroke, the overall average annual direct costs at 10 years (US dollars [USD] 5207) were comparable
to those for survivors between 3 and 5 years (USD5438). However, the contribution of some costs varied (eg, medications
contributed 13 at 5 years and 20 at 10 years). For intracerebral hemorrhage, annual direct costs were considerably
(24 ) greater at 10 years than estimated using 3 to 5 year data. Greater average lifetime costs per case were found using
the updated models (ischemic stroke: previous model USD51806 and current USD68 769; intracerebral hemorrhage:
previous model USD43 786 and current USD54 956 per case). Following sensitivity and multivariable uncertainty
analyses, the findings were robust.
Conclusions?Costs to 10 years after stroke have not previously been reported. Our findings demonstrate the importance of
estimating resource use over longer periods for forecasting lifetime estimates.
UR - http://stroke.ahajournals.org/content/45/11/3389.full.pdf
U2 - 10.1161/STROKEAHA.114.006200
DO - 10.1161/STROKEAHA.114.006200
M3 - Article
VL - 45
SP - 3389
EP - 3394
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 11
ER -