Aggressive tPA stroke treatment promises lower long-term costs

The FDA approved use of tissue plasminogen activator (tPA) for stroke in 1996, but it took another 10 years for the Centers for Medicare and Medicaid Services to offer reimbursement. The agency's decision is part of a larger trend that recognizes the value of preventive care and treatment compared with the cost of longer hospital stays.

"The idea of spending a lot of resources up front on stroke patients is gaining momentum. The fact that CMS recently raised the payment amount for acute stroke is recognition from the government that the acute care setting is a small fraction of the true costs of stroke management.

"If you spend more money on stroke patients in the first two days in the hospital, you can save money in the long run because the patients get better. Studies have shown that inpatient costs are about 3% of the overall costs of a stroke. If you double that amount and if you also reduce bad outcomes by 5%, you've more than paid for yourself, not to mention you have 5% more people with better outcomes."

-Dr. A. Greg Sorensen, a staff neuroradiologist at Massachusetts General Hospital and director of its Center for Biomarkers in Imaging.