Abstract
Objectives: To assess the cost effectiveness of community thrombolysis relative to hospital thrombolysis by investigating the extra costs and benefits of a policy of community thrombolysis, then establishing the extra cost per life saved by community thrombolysis.
Design: Economic evaluation based on the results of the Grampian region early anistreplase trial.
Setting: 29 rural general practices and one secondary care provider in Grampian, Scotland.
Subjects: 311 patients recruited to the Grampian region early anistreplase trial.
Interventions: Intravenous anistreplase given either by general practitioners or secondary care clinicians.
Main outcome measures: Survival at 4 years and costs of administration of thrombolysis.
Results: Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of £425 per patient. This gives a marginal cost of life saved at 4 years of £3890 (£1990 to £42 820).
Conclusions: The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase.
Design: Economic evaluation based on the results of the Grampian region early anistreplase trial.
Setting: 29 rural general practices and one secondary care provider in Grampian, Scotland.
Subjects: 311 patients recruited to the Grampian region early anistreplase trial.
Interventions: Intravenous anistreplase given either by general practitioners or secondary care clinicians.
Main outcome measures: Survival at 4 years and costs of administration of thrombolysis.
Results: Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of £425 per patient. This gives a marginal cost of life saved at 4 years of £3890 (£1990 to £42 820).
Conclusions: The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase.
| Original language | English |
|---|---|
| Pages (from-to) | 570-572 |
| Number of pages | 3 |
| Journal | British Medical Journal |
| Volume | 314 |
| Publication status | Published - 22 Feb 1997 |