Epidemiology and Social Costs
Pp. 3-22 (20)
Simone Peschillo and Francesco Diana
Stroke is a pathology that has a heavy socio-economic impact, considering
that the annual incidence is 15 million new cases and only one-third of these has a
positive clinical outcome. Stroke is the cause of 4% of all disabilities and it does,
therefore, have very high indirect social costs. The purpose of this chapter is to analyse
the societal costs of stroke and compare the various treatments in order to determine
which gives the best results for a contained cost.
Clinical outcome was analysed using the modified Rankin Scale (mRS), in which
patients are allocated a score that depends on the presence of neurological symptoms
and an impaired capacity to perform daily-life activities. The indirect costs related to
reduced productivity were calculated through the analysis of various indices: disabilityadjusted
life years (DAYLs), years of life lost (YLL) and years lived with disability
We calculated that a mRS score <2 obtained in 13.5% more of cases by using
endovascular treatment in patients with occlusion of large vessels rather than venous
fibrinolysis would lead to a saving of about 56 billion euros. Using data on the lifetime
cost of a stroke, we calculated that a saving of about 11,400 billion euros could be
achieved with endovascular treatment.
Clearly the savings are related to positive results that avoid indirect costs, in an ideal
situation in which all patients are treated with endovascular methods. In any case, the analysis is a mathematical demonstration of the notable potential of this therapeutic
Epidemiology, Healthcare, Incidence, Mortality, Prevalence,
Prevention, Risk factors, Social costs, Stroke.
Department of Neurology and Psychiatry, Endovascular Neurosurgery/Interventional Neuroradiology, ‘Sapienza’ University of Rome, Rome, Italy.