Understanding the Cost-Effectiveness of CTP or MRI Screening to Select Patients for IV tPA Treatment

photo of doctor looking at MRI image of brain

Decision-Analytic Model to Estimate Costs and Outcomes for Additional Screening for Ischemic Stroke Treatment

VALUE TO CLIENT

Our client was able to demonstrate that additional screening using CTP or MRI may increase overall acute care costs, but the benefit is large enough to make both highly cost-effective.

OPPORTUNITY

Our client wanted to understand if the costs of adding computed tomography perfusion (CTP) or magnetic resonance imaging (MRI) to the usual computed tomography (CT)-based methods for selecting ischemic stroke patients for intravenous recombinant tissue plasminogen activator (IV tPA) treatment would be offset by improved clinical outcomes.

CHALLENGE

We needed to address the lack of data available for evaluating the benefits of diagnostics like CT, CTP, and MRI.

APPROACH

  • Our team built decision-analytic models to estimate the costs and outcomes associated with penumbra-based CTP selection and penumbra-based MRI selection in a patient population like that enrolled in the IV tPA clinical trials. 
  • We obtained model inputs from published literature, clinical trial data, standard US costing sources, and expert opinion. 
  • We estimated cost per life-year saved and cost per QALY gained from a hospital perspective.