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. Author manuscript; available in PMC: 2015 Aug 1.
Published in final edited form as: J Stroke Cerebrovasc Dis. 2014 Jun 21;23(7):1753–1763. doi: 10.1016/j.jstrokecerebrovasdis.2014.02.017

Table 3. Methods and results of cost-of-illness studies for stroke patients, 1990-2012.

Prevalence-based studies
First author/
year of
publication/country 		Patients Study
designb 		Year of cost
(Study
period) 		Annual indirect cost in millions Proportion of total
cost represented by
indirect cost, %d
(Study period)
Stroke typea Age
range 		Local currency
(Study period) 		2012 USDc
(Study period)
Heindenreich, 2011, US20 All types (as a part of CVD) All HCA 2008 (2010∼2030) 25,600 (2010) e 44,400 (2030) e 27,299 (2010) e 47,347 (2030) e 47 (2010) 32 (2030)
Brown, 2006, US21 IS 45∼64 HCA, RA 2005 (2005∼2050) 1,177,000f (2005∼2050) 1,383,736f (2005∼2050) 53 (2005∼2050)
Chan, 1998, Canada (Ontario)23 All types (CI, ICH, SAH, TIA) Under 75 HCA 1994∼95 328e 381 e 38
Smith, 2012, Ireland27 All types and TIA All HCA, OC 2007 143∼248 g 176∼305 g 29–31
Gustavsson, 2011, European countries7 All types (as a part of brain disorders) Unclear Unclear 2010 4,932g, h N/Aj 8
Saka, 2009, UK37 All types Under 65 HCA, RA 2005 3,754 6,784 42
Pugliatti, 2008, Italy28 All types (as a part of brain disorders) Unclear HCA, RA 2004 792 g, h 1,189 g, h 23
Leal, 2006, EU39 All types (as a part of CVD) All HCA/FA, OC 2003 13,285 g 19,508 g 39
Luengo-Fernandez, 2006, UK38 All types (as a part of CVD) All HCA/FA, OC 2004 3,328 (HCA) 2,770 (FA) 6,137 (HCA) 5,108 (FA) 39 (HCA) 35 (FA)
Evers, 1997, Netherlands30 All types 18∼64 HCA 1993 566e 1,012e 22
Terént, 1994, Sweden36 All types Under 65 HCA 1991 (1983) 2,430 e 379 e 24
Scott, 1994, New Zealand42 IS 15–64 (n=912) HCA, OC/RA 1992 6∼14 h 7∼14 h 6∼9
Incidence-based studies
First author/
year of publication/
country 		Patients Study
designb 		Year of
cost
(Study
period) 		Annual indirect cost
in millions 		Per patient
indirect cost,
local currency
(2012 USD)c 		Proportion of
total cost
represented
by indirect
cost,%d
Stroke
typea 		Age
(sample
size) i 		Local
currency 		2012 USDc
Wiebers, 1992, US22 Unruptured intracranial aneurysms, aneurysmal SAH All (n=10,300/17,250) lifetime, HCA Unclear (1979,1984,1989) 309.8 (unruptured aneurysm), 1,242.5 (SAH) 507 (unruptured aneurysm), 2033 (SAH)k N/A 59 (unruptured aneurysm), 71 (SAH)
Taylor, 1996, US9 First SAH, ICH,IS All (n=N/A) lifetime, HCA 1990 23,600e 41,470 e N/A 58
Navarrete-Navarro, 2007, Spain32 First ICH survivors All (n=425) lifetime, HCA, RA 2004 N/A N/A 31,108g (54,067) 67
Ghatnekar, 2004, Sweden34 First all type Under 65 (n=4357) lifetime, HCA 2000 (first 6 months in 1997) N/A N/A 163,694 (male)e 86,586 (female) e (22,243/11,765) 25 (male) 14 (female)
Lopez-Bastida, 2012, Spain31 All type Under 65 (n=94) 1 year, HCA, OC 2004 N/A N/A 12,449 g (21,637) 71
Persson, 2012, Sweden (VästraGötaland county)33 First ICH, CI, stroke All (n=3074) 1 year, HCA, OC 2008 97 11 N/A 15
Dodel, 2010, Germany24 SAH Under 65 (n=101) 1 year, HCA, RA 2009 (2004∼2005) N/A N/A 17,350 g (22,850) 45
Rossnagel, 2005, Germany25 All types and TIA 18∼64 (n=383) 1 year, HCA 2002 N/A N/A 2,014e, g (2,960) 18
Weimar, 2003, Germany26 ICH All (n=266) 1 year, HCA Unclear (Jan. 1998 ∼ Oct. 1999) N/A N/A 5,537 e, g, k (8,053) 55
Zethraeus, 1999, Sweden35 All types (as a part of CVD) Under 64 (n=12) 1 year, HCA 1994 (1993∼1995) N/A N/A 71,731e (10,229) N/A
Gerzeli, 2005, Italy29 First IS and hemorrhage Over 18 (n=449) 6 months, HCA, OC/RA 1998 N/A N/A 5,026 g (8,691) 43
Cadilhac,2009, Australia40 First IS and ICH Unclear (n=4291/27660) lifetime, FA 2004 12.8 (ICH)h 46.5 (IS) h 10 (ICH)h 38 (IS) h N/A 5 (ICH) 3 (IS)
Dewey, 2001, Australia41 First CI, ICH, and unclassified stroke Under 65 (n=165) 1 year, FA, OC 1997 (May 1996 ∼April 1997) 56 56 N/A 10

Notes:

a

CVD (cardiovascular disease, includes hypertension, coronary heart disease, heart failure, stroke, and all other cardiovascular disease); ICH (intracerebral hemorrhagic stroke); IS (ischemic stroke); SAH (subarachnoid hemorrhage); TIA (transient ischemic attack); CI (cerebral infarction); N/A (not available).

b

Estimation approaches for productivity loss: HCA (the human capital approach), and FA (the friction cost approach). Estimation approaches for the time cost of informal caregiving: OC (the opportunity cost approach), and RA (the replacement approach).

c

Indirect cost in 2012 USD is estimated by using consumer price indices of study countries in the years of cost and in 2012 from the World Bank (http://data.worldbank.org/indicator/FP.CPI.TOTL) and purchasing power parity (PPP) exchange rate in 2012 from OECD website (http://stats.oecd.org/Index.aspx?datasetcode=SNA_TABLE4).

d

The proportion of total cost represented by indirect cost = (indirect cost/total cost) × 100. Total cost includes both direct and indirect cost.

e

Cost of informal caregiving is not included in indirect cost. Also, the total cost does not include the cost of informal caregiving.

f

Costs are accumulated costs during study periods.

g

Euro is used as a local currency.

h

The cost of informal caregiving is included in direct cost and is not separable from that cost. In the calculation of the proportion of total cost represented by indirect cost, the cost of informal caregiving is included in the total cost but not in indirect cost.

i

When the sample size of the indirect cost is different from the total sample size, the sample size for indirect cost is shown.

j

Because indirect cost of each country was not provided, we cannot estimate indirect cost in 2012 ISD.

k

We assume that the year of cost is the publication year.