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Stroke-related costs to double by 2030

MANAGED CARE July 2013. © MediMedia USA
Managed Care Outlook

Stroke-related costs to double by 2030

The cost of treating stroke victims will soar in the next two decades, according to a study by the American Heart Association and the American Stroke Association that was published in the journal Stroke. Real total direct annual stroke-related medical costs are expected to increase from $72 billion to $183 billion (2010 dollars) between 2012 and 2030.

That’s not the entire story.

“Overall total annual costs of stroke are projected to increase to $240.67 billion by 2030, an increase of 129 percent,” the study states. Indirect costs include lost productivity from morbidity and premature mortality.

The main reason is that “the aging of the United States population in coming decades has the potential to increase stroke cost substantially, because the risk of stroke is higher for older ages.”

Bruce Ovbiagele, MD, the main author of the study, says, “Strokes will absolutely strain the health care system. Only 10 percent recover completely after a stroke.”

Policy changes can help address the problem. The authors cite a study in the New England Journal of Medicine (“Full Coverage for Preventive Medications After Myocardial Infarction,” Dec. 1, 2011 — http://tinyurl.com/preventive-meds) reporting that “eliminating copayments for relatively inexpensive, commonly used medications for prevention of cardiovascular events resulted in improved medication adherence and reduced the rate of vascular events, while significantly reducing costs for patients — without increasing the insurer’s health care cost.” (This looks like value-based plan design, something we’ve covered for years, including this cover story from 2009 — http://tinyurl.com/value-based.)

“Getting patients specialized acute stroke care as soon as possible is critical,” says Ovbiagele, who is a professor and chairman of the department of neurology at the Medical University of South Carolina in Charleston. “During every minute of delayed treatment, brain cells are dying. EMS systems nationwide should take patients directly to a designated stroke center equipped to quickly diagnose and administer drugs to restore blood flow to the brain.”

The study asserts that health reform might alleviate some of the problem. The Affordable Care Act “provides an unprecedented emphasis on the provisions of evidence-based clinical preventive services and calls for a substantial investment in community-based prevention strategies that may help to reduce the growing future burden of stroke.”

Larger aged population means many more strokes

Projected total (direct and indirect) costs of all stroke by age, 2012 to 2030 (in billions of 2010 dollars).

Projected total costs of all stroke by age

Source: “Forecasting the Future of Stroke in the United States,” Stroke, May 2013