Long-term costs differ for ischemic, hemorrhagic stroke
In the first study to include 10 years of follow-up data on stroke cost estimates, the average annual direct costs of ischemic stroke at 10 years were similar to costs at 3 to 5 years; however, for intracerebral hemorrhage, average annual direct costs were greater at 10 years compared with costs at 3 to 5 years.
Researchers in Australia analyzed data from the North East Melbourne Stroke Incidence Study to determine whether modeling lifetime costs based on estimates to 5 years after stroke is accurate. After interviewing 243 patients with ischemic stroke and 43 patients with hemorrhagic stroke who had survived for 10 years or more, the researchers categorized resource use at 10 years and, based on those figures, recalculated lifetime costs of ischemic stroke and hemorrhagic stroke.
For ischemic stroke, overall average annual direct costs at 10 years were $5,207, comparable to annual cost between 3 and 5 years, which was $5,438. For hemorrhagic stroke, overall average annual direct costs were 24% greater at 10 years ($7,607) than costs at 3 to 5 years ($5,807).
“We did not know that the cost differentials would be so great between ischemic stroke and intracerebral hemorrhage, and that short-term estimates (6 to 12 months after a first stroke) used to approximate lifetime annual resource use after the first year would not be a good predictor of future costs,” Dominique Cadilhac, PhD, associate professor and head of the translational public health unit of the Stroke and Ageing Research Centre at Monash University in Victoria, Australia, said in a press release.
After recalculating the lifetime costs of stroke based on the 10-year data and updated prices and population demographic statistics, the researchers determined that the average lifetime costs per survivor are now higher than previously calculated:
- Ischemic stroke: previous model, $51,806; new model, $68,769.
- Hemorrhagic stroke: previous model, $43,786; new model, $54,956.
Sensitivity and multivariable uncertainty analyses determined the findings to be robust.
“Much could be gained if we could work to prevent the majority of strokes that are due to modifiable risk factors, such as high [BP] or diabetes,” Cadilhac stated in the release. “We hope that our findings can be used to influence the need for more primary prevention and to also support assessment of the cost effectiveness of interventions to reduce disability from stroke.”
Disclosure: The researchers report no relevant financial disclosures.