title: Cost-effectiveness analysis of the neuroprotective agent edaravone for noncardioembolic cerebral infarction.
abstract: BACKGROUND
  The free radical scavenger edaravone has been reported useful for improvement in activities of daily living and for prevention of recurrent stroke in the edaravone versus sodium ozagrel in acute noncardioembolic ischemic stroke (EDO) trial. The aim of this report was to evaluate the cost-effectiveness of edaravone compared to the intravenous antiplatelet drug ozagrel sodium (ozagrel) for noncardioembolic stroke (non-CES) based on the EDO trial data.
  
  
  METHODS
  A cost-effectiveness analysis was performed using the Markov model, which also incorporated the long-term course after the acute stage of non-CES. From the perspective of a health care payer, direct medical costs and nursing care costs were taken into account in the cost analysis. The quality-adjusted life year (QALY) served as an indicator of effectiveness. Simulation at 5 and 10 years after the onset of non-CES was carried out. The study involved 68-year-old patients with non-CES, selected against the EDO trial subject selection criteria. A 14-day treatment with edaravone 60 mg/day or ozagrel 160 mg/day was assumed as acute treatment for non-CES.
  
  
  RESULTS
  The use of edaravone was associated with a reduction in total costs (0.51 million yen [$6,374] at 5 years and 0.64 million yen [$8,039]) at 10 years after the onset of non-CES) and improvement in QALYs (0.23 at 5 years and 0.38 at 10 years). Compared to ozagrel therapy, edaravone therapy was a cost-saving strategy for treating non-CES.
  
  
  CONCLUSIONS
  Compared to ozagrel therapy, edaravone therapy for non-CES is not only useful from a clinical viewpoint, but also valuable from a socioeconomic perspective.
authors.affiliation: Department of Neurology, Federation of National Public Service Personnel Mutual Aid Associations, Tachikawa Hospital, Tachikawa, Tokyo, Japan. yshinoha@tachikawa-hosp.gr.jp
authors.forename: Yukito
authors.initials: Y
authors.lastname: Shinohara
authors.forename: Sachie
authors.initials: S
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000983:Antipyrine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000175:diagnosis / Q000191:economics* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D003198:Computer Simulation; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D000077553:Edaravone; D005260:Female; D016166:Free Radical Scavengers / Q000191:economics* / Q000627:therapeutic use*; D017721:Hospital Costs; D006801:Humans; D020766:Intracranial Embolism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D008297:Male; D008390:Markov Chains; D008689:Methacrylates / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic; D018696:Neuroprotective Agents / Q000191:economics* / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000191:economics / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D055502:Secondary Prevention / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016166:Free Radical Scavengers; D008689:Methacrylates; D018696:Neuroprotective Agents; D010975:Platelet Aggregation Inhibitors; C034364:ozagrel; D000077553:Edaravone; D000983:Antipyrine