TY - JOUR T1 - The cost of providing mechanical thrombectomy in the UK NHS: a micro-costing study JF - Clinical Medicine JO - Clin Med SP - e40 LP - e45 DO - 10.7861/clinmed.2019-0413 VL - 20 IS - 3 AU - Joyce S Balami AU - Diamuid Coughlan AU - Phil M White AU - Peter McMeekin AU - Darren Flynn AU - Christine Roffe AU - Indira Natarajan AU - Jayan Chembala AU - Sanjeev Nayak AU - Ivan Wiggam AU - Peter Flynn AU - Robert Simister AU - Yazen Sammaraiee AU - Don Sims AU - Kurdow Nader AU - Anand Dixit AU - Dawn Craig AU - Hannah Lumley AU - Stephen Rice AU - David Burgess AU - Lisa Foddy AU - Emer Hopkins AU - Beverley Hudson AU - Rachael Jones AU - Martin A James AU - Alastair M Buchan AU - Gary A Ford AU - Alastair M Gray Y1 - 2020/05/01 UR - http://www.rcpjournals.org/content/20/3/e40.abstract N2 - Introduction The clinical efficacy and cost-effectiveness of mechanical thrombectomy (MT) for the treatment of large vessel occlusion stroke is well established, but uncertainty remains around the true cost of delivering this treatment within the NHS. The aim of this study was to establish the cost of providing MT within the hyperacute phase of care and to explore differences in resources used and costs across different neuroscience centres in the UK.Method This was a multicentre retrospective study using micro-costing methods to enable a precise assessment of the costs of MT from an NHS perspective. Data on resources used and their costs were collected from five UK neuroscience centres between 2015 and 2018.Results Data were collected on 310 patients with acute ischaemic stroke treated with MT. The mean total cost of providing MT and inpatient care within 24 hours was £10,846 (95% confidence interval (CI) 10,527–11,165) per patient. The main driver of cost was MT procedure costs, accounting for 73% (£7,943; 95% CI 7,649–8,237) of the total 24-hour cost. Costs were higher for patients treated under general anaesthesia (£11,048; standard deviation (SD) 2,654) than for local anaesthesia (£9,978; SD 2,654), mean difference £1,070 (95% CI 381–1,759; p=0.003); admission to an intensive care unit (ICU; £12,212; SD 3,028) against for admission elsewhere (£10,179; SD 2,415), mean difference £2,032 (95% CI 1,345–2,719; p<0001).The mean cost within 72 hours was £12,440 (95% CI 10,628–14,252). The total costs for the duration of inpatient care before discharge from a thrombectomy centre was £14,362 (95% CI 13,603–15,122).Conclusions Major factors contributing to costs of MT for stroke include consumables and staff for intervention, use of general anaesthesia and ICU admissions. These findings can inform the reimbursement, provision and strategic planning of stroke services and aid future economic evaluations. ER -