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Cost-Effectiveness Analysis of Percutaneous Patent Foramen Ovale Closure Preventing Secondary Ischemic Stroke in Japan.
Inoue, Sachie; Igarashi, Ataru; Iguchi, Yasuyuki; Akagi, Teiji.
Afiliación
  • Inoue S; CRECON Medical Assessment Inc., Tokyo, Japan. Electronic address: sachie.inoue@crecon.jp.
  • Igarashi A; Unit of Public Health and Preventive Medicine, Yokohama City University School of Medicine, Kanagawa, Japan; Department of Health Economics and Outcomes Research, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
  • Iguchi Y; Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
  • Akagi T; Department of Cardiovascular Medicine, Okayama University, Okayama, Japan.
J Stroke Cerebrovasc Dis ; 30(8): 105884, 2021 Aug.
Article en En | MEDLINE | ID: mdl-34153592
OBJECTIVES: Patent foramen ovale is a hemodynamically insignificant interatrial communication that may cause ischemic stroke. Percutaneous patent foramen ovale closure reduces the risk for recurrent ischemic stroke in patients with a history of cryptogenic ischemic stroke. This study evaluated the cost-effectiveness of patent foramen ovale closure against medical therapy in patients after their first cryptogenic ischemic stroke in Japan. MATERIALS AND METHODS: The cost-effectiveness of patent foramen ovale closure compared with medical therapy was evaluated using the Markov model. The target patients started with patent foramen ovale closure or medical therapy for preventing secondary ischemic stroke under a stable state. Quality-adjusted life year was used as the outcome of effectiveness, and the analysis was conducted with a discount rate of 2% applied to both cost and effectiveness. The results of a multicenter open-label randomized controlled trial (RESPECT trial) evaluating patent foramen ovale closure using the Amplatzer™ PFO Occluder were used as clinical evidence. Cost-effectiveness was evaluated using the incremental cost-effectiveness ratio. It was evaluated as cost-effective if it was lower than 5 million JPY/ quality-adjusted life year. RESULTS: Patent foramen ovale closure was dominant over medical therapy by 2.53 quality-adjusted life years and an estimated cost reduction of 2,353,926 JPY. The probability of patent foramen ovale closure being dominant was 82.9%. CONCLUSIONS: Patent foramen ovale closure was dominant over medical therapy for preventing secondary ischemic stroke in patients with cryptogenic ischemic stroke.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Cardíaco / Costos de la Atención en Salud / Foramen Oval Permeable / Dispositivo Oclusor Septal / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cateterismo Cardíaco / Costos de la Atención en Salud / Foramen Oval Permeable / Dispositivo Oclusor Septal / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Límite: Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos