Cost-effectiveness of edaravone dexborneol versus edaravone for the treatment of acute ischemic stroke in China: Based on the TASTE study

Abstract

Background and purpose: The TASTE trial indicated that patients with acute ischemic stroke (AIS) using edaravone dexborneol have a significantly higher proportion of 90-day good functional outcomes (mRS 0–1) than those using edaravone. This study compared the cost-effectiveness of the aforementioned interventions in treating AIS in the Chinese setting, aiming to inform treatment decisions in clinical practice.Methods: A model combining a decision tree and a Markov model was developed to assess the cost-effectiveness of edaravone dexborneol versus edaravone for AIS over a 30-year time horizon from the Chinese healthcare system’s perspective. Both efficacy and safety data were extracted from the TASTE study. Local costs and utilities were derived from publications and open-access databases; both cost and effectiveness were discounted at a rate of 5% per year. Sensitivity analyses were conducted to ensure robustness and identify the main drivers of the result.Results: Compared with edaravone, edaravone dexborneol for AIS was found to be cost-effective in the first year and highly cost-effective as the study time horizons extended. In the long term (30 years), edaravone dexborneol yielded a lifetime gain of 0.25 (0.07–0.45) quality-adjusted life years (QALYs) at an additional cost of CNY 2201.07 (-3,445.24–6,637.23), yielding an ICER of CNY 8823.41 per QALY gained under the willingness-to-pay (WTP) of 1.5 times per capita GDP (121,464 CNY). The result is robust in both deterministic and probabilistic sensitivity analysis (PSA) methods, with the advantage of the edaravone dexborneol strategy increasing over time. Specifically, the probability of edaravone dexborneol dominant dexborneol is 76.30%, 98.90%, and 99.50% over 1-, 5-, and 30-year time horizons.Conclusion: Both short- and long-term economic analyses suggest that edaravone dexborneol is highly likely to be a cost-effective alternative to treat AIS compared with edaravone in China.

Cost-effectiveness of edaravone dexborneol versus dl-3-n-butylphthalide for the treatment of acute ischemic stroke: a Chinese health care perspective

“…According to the one-way sensitivity analysis, the top factor with great influence on ICER was the price of ED, followed by the price of NBP, which were different from the findings of cost-effectiveness of ED versus edaravone for the treatment of AIS in China by Shi FH, et al [ 18 ]. The price of ED was lower, the treatment of ED was more cost-effective.…”

“…Excess death rate due to stroke was incorporated into the long-term Markov model as the hazard ratio for each mRS health state by using the age-specific death rate multiplied by the hazard ratio for each mRS health state [ 18 ]. The stroke death hazard ratio of mRS 0–1 and mRS 2–5 contracted from the published study by Boudreau et al [ 19 ].…”

Efficacy and safety of blood-activating herbs combined with edaravone in the treatment of acute ischemic stroke: A protocol for systematic review and meta-analysis

“…[14] Studies have shown that multiple pathways of injury in the ischemic cascade are simultaneous and interact with each other; therefore, combined therapy targeting several pathways of ischemic injury may have advantages over single pathway strategies. [15]…”

“…[14] Studies have shown that multiple pathways of injury in the ischemic cascade are simultaneous and interact with each other; therefore, combined therapy targeting several pathways of ischemic injury may have advantages over single pathway strategies. [15] Free radicals are the main cause of ischemic cerebrovascular injury, and the massive production of free radicals after brain tissue injury promotes secondary brain tissue damage. EDA is a potent free radical scavenger.…”

EDB-mediated neuroprotection against acute ischemic brain injury is associated with reduced central and peripheral inflammation

“…Given the synergistic effect of edaravone (anti-oxidant) and borneol (anti-in ammation), edaravone dexborneol (EDB), which is composed of edaravone and (+)-borneol at a 4:1 ratio, has been tested as a multitarget agent, and it is satisfactory in protect against brain ischemia. Phase II/III study con rmed the e cacy and safety of EDB in clinical patients with AIS [18][19][20]. However, the immunomodulatory effects of EDB on the central and peripheral immune systems after stroke have not been elucidated elaborately.…”