Stroke is still a major cause of death and healthcare use across Europe. Even with progress in acute care, long-term secondary prevention remains patchy, leading to repeat events and ongoing burden.
The ABCstroke pathway, developed by the ESC Council on Stroke, offers a structured and integrated approach to post-stroke care built around three areas: appropriate antithrombotic therapy (A), better functional and psychological status (B), and cardiovascular risk factor and comorbidity optimisation (C).
While following the ABCstroke pathway has been linked to better outcomes in observational studies, its economic value has not been previously assessed.
In a recent analysis published by the ESC Council on Stroke in the European Heart Journal – Quality of Care and Clinical Outcomes, we examined the long-term cost-effectiveness of the pathway in the UK.
Using a Markov modelling approach informed by the Athens Stroke Registry and UK-specific cost and utility data from the Oxford Vascular Study, lifetime outcomes following ischaemic stroke were simulated.
Over 20-years, patients receiving pathway-aligned care had higher quality of life-adjusted survival (9.84 vs. 5.94 QALYs) and a lower incremental cost per QALY gained (£14,804), showing that the ABCstroke pathway improves outcomes and is cost-effective.
In conclusion, the ABCstroke pathway is cost-effective in the UK healthcare setting. Further analyses in other healthcare settings are under way and may help support wider adoption and guide investment in structured, multidisciplinary secondary stroke prevention.
