Keywords: Stroke, MR Value
Motivation: MRI has been shown to identify patients with salvageable brain tissue in stroke patients presenting with unknown onset. The WAKE-UP trial demonstrated a clinical benefit of such MRI-guided IV thrombolysis (IVT) over best supportive care (BSC).
Goal(s): We aimed to determine the cost-effectiveness of this management strategy.
Approach: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALY) associated with MRI-guided IVT or BSC.
Results: The base-case analysis identified MRI-guided IVT as the strategy that resulted in incremental QALYs and cost-savings over the projected lifetime compared to BSC (IC: -$21,481; IE: +0.62 QALYs; ICER: IVT dominant).
Impact: MRI-guided IVT is projected to provide long-term clinical benefit whilst also leading to cost-savings in the management of stroke patients with unknown onset. Based on the projected health and cost benefits, investments to support the required MRI infrastructure are justified.
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