This study aims to analyze the cost-utility of the add-on of Dengzhan Shengmai (DZSM) capsule with standard medical therapy and standard medical therapy alone in secondary stroke prevention.

A Markov model was constructed based on the societal perspective and the costs and health unities were simulated for a time horizon of 5 years. The model included 4 health states, included healthy, recurrent stroke-independent (mRS0-2), recurrent stroke-dependent (mRS3-5) and death. Clinical data and utilities for the modelling analysis were obtained from published literatures. Direct costs included medication costs obtained from public database, and costs for hospitalization, post-discharge rehabilitation service, and secondary prevention were sourced from published literatures. 2019 inflation-adjusted costs were calculated using Consumer Price Index (CPI) for medical care. Indirect costs included loss of salary for patients and their families caused by the disease which were derived from China statistical yearbook.

Base-case analysis results showed that the incremental costs of DZSM group (29 284 RMB) over 5 years were higher than the control group (21 551 RMB). The incremental health utilities of DZSM group (3.91 QALYs) over 5 years were also greater than the control group (3.81 QALYs). The incremental costs of the two group were 7 734 RMB, while the incremental utilities were 0.1 QALYs. The incremental cost-utility ratio was 74 479 RMB/QALY, which equals to approximately 1.05 times of GDP per capita and less than 3 times of GDP per capita, indicating that the add-on of DZSM capsule with standard medical therapy were more cost-effective. Sensitivity analyses revealed robust results.

Compared to standard medical therapy alone, the add-on of DZSM capsule has economic advantages in secondary stroke prevention.