Abstract Background and aims Evidence on costs and health-related quality of life (HRQoL) after stroke beyond the first year is limited. This study estimated societal costs over 3-month period and HRQoL at 2 and 3 years post-stroke, and examined differences by functional outcome in the Netherlands. Methods Stroke patients were recruited from the MR CLEAN MED and MR CLEAN NO IV trials. HRQoL and cost data were collected using telephone interviews and questionnaires. HRQoL was assessed using EQ-5D-5L and expressed as utility values. Functional outcome was assessed using the modified Rankin Scale (mRS). Costs were estimated from a societal perspective using non-parametric bootstrapping and categorized into healthcare and non-healthcare costs. Results In total, 297 patients were included, with follow-up available for 108 patients at 2 years and 189 patients at 3 years post-stroke. Mean utility was 0.77 (SD 0.28) at 2 years and 0.79 (SD 0.27) at 3 years. Mean total 3-month costs per patient were €7,487 (95% CI €5,482–€9,808) at 2 years and €7,098 (95% CI €5,118–€9,521) at 3 years. Non-healthcare costs accounted for 37% of total costs at 2 years and 41% at 3 years. Total 3-month costs increased substantially with worse functional outcome, ranging from €2,288 (mRS0) to €29,879 (mRS5) at 2 years, and from €448 (mRS0) to €46,389 (mRS5) at 3 years. Conclusions Societal costs remain substantial at long-term follow-up after stroke, particularly among patients with severe disability. Targeting functional recovery may reduce long-term economic burden. Conflict of interest Chi Nguyen: nothing to disclose. Jasper Daems: nothing to disclose. Hassan Al Ameer: nothing to disclose. Manon Kappelhof: nothing to disclose. Diederik Dippel: nothing to disclose. Yvo Roos is a minor shareholder of Nicolab. Durk-Jouke van der Zee is a member of the supervisory board Radiotherapeutisch Instituut Friesland. Erik Buskens reports grants from ZonMw and Dutch Heart Foundation. Maarten Uyttenboogaart reports grants from ZonMw and the Dutch Hearth Foundation. Maarten Lahr: nothing to disclose.
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Chi Nguyen
Jasper Daems
Hassan Al Ameer
European Stroke Journal
University of Amsterdam
University of Groningen
Erasmus MC
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Nguyen et al. (Fri,) studied this question.
www.synapsesocial.com/papers/69fd7fa1bfa21ec5bbf0837b — DOI: https://doi.org/10.1093/esj/aakag023.709
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