Cost-utility analysis in acute ischemic stroke survivors treated with dapsone in a public hospital in Mexico City

Objective Stroke is the leading cause of disability and death in the world. Each year, 15 million people worldwide suffer strokes. This study aims to analyze the relationship between the economic consequences and the units of utility in Mexican acute ischemic stroke (AIS) survivors who attended the National Institute of Neurology and Neurosurgery in Mexico City and who were treated with dapsone (a neuroprotective drug) versus placebo in addition to conventional treatment. Methods This cost–utility analysis was done in the context of a clinical trial with a follow-up period of 3 months. In the clinical trial, dapsone efficacy versus placebo was measured in patients who presented with an AIS that also were receiving conventional therapy. Efficacy was also obtained from a published article that used dapsone to treat patients with AIS. A meta-analysis was conducted in order to obtain dapsone efficacy with a 95% confidence interval. The economic medical and nonmedical costs were calculated. The utility was evaluated using the Stroke Specific Quality of Life questionnaire, Spanish version. A Markov model was used. Key findings Twenty-nine patients with AIS were included, with an average age of 62.2 years (interval 23–90 years), and 62.1% were women. Dapsone cost–utility ratio was US$14612.79/quality-adjusted life year (QALY) versus placebo US$18631.84/QALY. The incremental cost-effectiveness ratio was US$49 700.05/QALY gained with dapsone. The sensitivity analysis of results was not sensitive to the variation of costs and/or QALYs. Conclusions The use of dapsone in AIS patients is a favourable option regarding cost–utility in comparison with placebo.