A clot-busting drug called tissue plasminogen activator (tPA) is among the most costly medicines on the market. A single dose costs $2000. But according to findings presented at the American Heart Association's annual conference on stroke research in Anaheim, California, it can lower overall health care costs for stroke patients. The drug saves money because it reduces the incidence of disabilities such as paralysis and loss of speech, which means that patients who receive it spend fewer days in the hospital and are less likely to require nursing-home care.
That upbeat conclusion was reached by a team of researchers led by Susan Fagan of Wayne State University College of Pharmacy in Detroit and neurologist Lewis Morgenstern of the University of Texas Medical School in Houston who reanalyzed data from the National Institutes of Health's tPA study released in December 1995. The study, which included 624 patients, showed that tPA can reduce long-term disabilities if it is given within 3 hours of the onset of a stroke due to a blood clot in the brain. Stokes caused by blood clots account for 70% to 80% of all strokes and will strike some 500,000 Americans this year.
Fagan's team developed a computer model to compare costs for study participants who received tPA with those incurred by patients who received a placebo. They found that tPA increased hospital costs by $2 million for every 1000 stroke patients treated, but reduced nursing-home costs by $4.8 million and rehabilitation costs by $2 million. Patrick Lyden, a neurologist at the University of California, San Diego, says the "rigorous" study shows that tPA is a rare example of a medical breakthrough that "not only saves lives and disability, but also saves money."