OBJECTIVES : Intravenous thrombolysis (IVT) with alteplase and mechanical thrombectomy (MT) are widely used in Hungary in the management of acute ischemic stroke (AIS), however, there is a lack of data on the actual cost of these procedures. Our aim is to assess the cost of AIS cases from provider’s perspective.

METHODS : Using the Stroke Registry of University of Pécs we included AIS patients registered between 2018 January and 2019 June treated with IVT or MT or both. We retrieved data from the electronic medical record on resource utilization such as length of stay (LOS) from every department they have visited during their stroke treatment. We have collected patient level data on the cost of laboratory, radiological and other diagnostical procedures. Unit costs were provided by the accounting department regarding cost of one patient day (including nursing, doctors’ salary, equipment, drugs, and capital cost), and cost of MT. We assigned costs to patients individually to determine the patient level cost of care.

RESULTS : We have identified 194 AIS patients, 113 only IVT, 49 only MT, and 32 IVT+MT. Average cost of IVT with alteplase was 552±110 €. Average cost of MT surgery was 4094±1712 €. Average LOS was 6.6±6.3, 10.5±12.2, 8.7±6.2 days; average cost of hospitalization was 1575±1872, 2392±2501, 2062±1348 €; average cost of diagnostic procedures was 252±144, 290±98, 325±92 €; total cost of care was 2390±1992, 6781±3042, 6984±1798 € for IVT, MT and IVT+MT patient groups respectively.

CONCLUSIONS : Both MT itself and MT combined with IVT are very expensive procedures. Due to the increasing number of patients treated with MT, it is important to assess the cost-effectiveness of this technique in the local population to evaluate value for money. Our data and cost collecting methods make further cost-effectiveness studies possible.