P67 Short-Term Cost-Effectiveness of a Remote Robotic Mechanical Thrombectomy System

Mechanical thrombectomy (MT) is a treatment for acute ischemic stroke (AIS). The clinical effect of MT AIS patients suffering large-vessel occlusion, highly time-dependent. Patients admitted to primary center (PSC) currently must be transferred comprehensive (CSC) MT. A remote robotic system has the potential disrupt care pathway by allowing performance at PSC an interventional radiologist physically located in CSC. We developed discrete event simulation (DES) model simulate evaluate short term costs and quality-adjusted life-years (QALY) within first 90 days. Cost components included were procedure costs. No long or chronic included. performed probabilistic sensitivity analyses (PSA) assess uncertainty results. Baseline results indicated that both more costly (by $1,259) effective 0.01 QALY) than patient transfer from CSC procedure, corresponding incremental cost-effectiveness ratio (ICER) $148,202. In 10,000 1-st order trials strategy led 2% (31/1521) fewer deaths, 1.8% (62/3533) functionally independent (modified Rankin Score (mRS) 0-2 days), 0.6% (31/4946) dependent (mRS 3-5 days). Robotic was cost-effective 5% 53% PSA iterations using threshold $100,000/QALY $150,000/QALY, respectively. Remote saves lives, increases number with functional independence, decreases dependence. If only cost health effects are considered, ICER above $100,000 threshold, but below $150,000 threshold.