Cover Image

Regional and national differences in stroke thrombolysis use and disparities in pricing, treatment availability, and coverage

BACKGROUND: Major disparities have been reported in recombinant tissue plasminogen activator (rtPA) availability among countries of different socioeconomic status. - AIMS: To characterize variability of rtPA price, its availability, and its association with and impact on each country's health e...

Full description

Saved in:
Bibliographic Details
Main Authors: Souza, Ana Claudia de (Author) , Sebastian, Ivy Anne (Author) , Zaidi, Wan Asyraf Wan (Author) , Nasreldein, Ahmed (Author) , Bazadona, Danira (Author) , Amaya, Pablo (Author) , Elkady, Ahmed (Author) , Gebrewold, Meron Awraris (Author) , Vorasayan, Pongpat (Author) , Yeghiazaryan, Nune (Author) , Michel, Patrik (Author) , Khatri, Pooja (Author) , Pandian, Jeyaraj Durai (Author) , Martins, Sheila Cristina Ouriques (Author) , Hacke, Werner (Author) , Lioutas, Vasileios-Arsenios (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: International journal of stroke
Year: 2022, Volume: 17, Issue: 9, Pages: 990-996
ISSN:1747-4949
DOI:10.1177/17474930221082446
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/17474930221082446
Verlag, Volltext: https://journals.sagepub.com/doi/10.1177/17474930221082446
Get full text
Author Notes:Ana Claudia de Souza, Ivy Anne Sebastian, Wan Asyraf Wan Zaidi, Ahmed Nasreldein, Danira Bazadona, Pablo Amaya, Ahmed Elkady, Meron Awraris Gebrewold, Pongpat Vorasayan, Nune Yeghiazaryan, Patrik Michel, Pooja Khatri, Jeyaraj Durai Pandian, Sheila Cristina Ouriques Martins, Werner Hacke, and Vasileios-Arsenios Lioutas
Description
Summary:BACKGROUND: Major disparities have been reported in recombinant tissue plasminogen activator (rtPA) availability among countries of different socioeconomic status. - AIMS: To characterize variability of rtPA price, its availability, and its association with and impact on each country's health expenditure (HE) resources. - METHODS: We conducted a global survey to obtain information on rtPA price (50 mg vial, 2020 US Dollars) and availability. Country-specific data, including low, lower middle (LMIC), upper middle (UMIC), and high-income country (HIC) classifications, and gross domestic product (GDP) and HE, both nominally and adjusted for purchasing power parity (PPP), were obtained from World Bank Open Data. To assess the impact of rtPA cost, we computed the rtPA price as percentage of per capita GDP and HE and examined its association with the country income classification. - RESULTS: rtPA is approved and available in 109 countries. We received surveys from 59 countries: 27 (46%) HIC, 20 (34%) UMIC, and 12 (20%) LMIC. Although HIC have significantly higher per capita GDP and HE compared to UMIC and LMIC (p < 0.0001), the median price of rtPA is non-significantly higher in LMICs (USD 755, interquartile range, IQR (575-1300)) compared to UMICs (USD 544, IQR (400-815)) and HICs (USD 600, IQR (526-1000)). In LMIC, rtPA cost accounts for 217.4% (IQR, 27.1-340.6%) of PPP-adjusted per capita HE, compared to 17.6% (IQR (11.2-28.7%), p < 0.0001) for HICs. - CONCLUSION: We documented significant variability in rtPA availability and price among countries. Relative costs are higher in lower income countries, exceeding the available HE. Concerted efforts to improve rtPA affordability in low-income settings are necessary.
Item Description:First published: February 9, 2022
Gesehen am 14.11.2022
Physical Description:Online Resource
ISSN:1747-4949
DOI:10.1177/17474930221082446

Similar Items