{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:06:38Z","timestamp":1791594398440,"version":"4.3.4"},"reference-count":42,"publisher":"BMJ","issue":"2","funder":[{"name":"Beijing Municipal Commission of Health and Family Planning"},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Ministry of Science and Technology of the People\u2019s Republic of China"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,17]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Endovascular mechanical thrombectomy is an effective but expensive therapy for acute ischaemic stroke with proximal anterior circulation occlusion. This study aimed to determine the cost-effectiveness of mechanical thrombectomy in China, which is the largest developing country.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A combination of decision tree and Markov model was developed. Outcome and cost data were derived from the published literature and claims database. The efficacy data were derived from the meta-analyses of nine trials. One-way and probabilistic sensitivity analyses were performed in order to assess the uncertainty of the results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Hospitals in China.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>The patients with acute ischaemic stroke caused by proximal anterior circulation occlusion within 6\u2009hours.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Mechanical thrombectomy within 6\u2009hours with intravenous tissue plasminogen activator (tPA) treatment within 4.5\u2009hours versus intravenous tPA treatment alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcome measures<\/jats:title>\n                  <jats:p>The benefit conferred by the treatment was assessed by estimating the cost per quality-adjusted life-year (QALY) gained in the long term (30 years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The addition of mechanical thrombectomy to intravenous tPA treatment compared with standard treatment alone yielded a lifetime gain of 0.794 QALYs at an additional cost of CNY 50 000 (US$7700), resulting in a cost of CNY 63 010 (US$9690) per QALY gained. The probabilistic sensitivity analysis indicated that mechanical thrombectomy was cost-effective in 99.9% of the simulation runs at a willingness-to-pay threshold of CNY 125 700 (US$19 300) per QALY.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Mechanical thrombectomy for acute ischaemic stroke caused by proximal anterior circulation occlusion within 6\u2009hours was cost-effective in China. The data may be used as a reference with regard to medical resources allocation for stroke treatment in low-income and middle-income countries as well as in the remote areas in the developed countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-018951","type":"journal-article","created":{"date-parts":[[2018,2,22]],"date-time":"2018-02-22T09:28:32Z","timestamp":1519291712000},"page":"e018951","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":51,"title":["Cost-effectiveness of mechanical thrombectomy within 6 hours of acute ischaemic stroke in China"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3082-6789","authenticated-orcid":false,"given":"Yuesong","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Centre for Neurological 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China"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingquan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Centre for Neurological Diseases, Beijing, China"},{"name":"Centre of Stroke, Beijing Institute for Brain Disorders, Beijing, China"},{"name":"Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China"},{"name":"China National Clinical Research Centre for Neurological Diseases, Beijing, China"},{"name":"Centre of Stroke, Beijing Institute for 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