Stroke remains a leading cause of mortality and healthcare use across Europe. Despite advances in acute management, long-term secondary prevention remains fragmented, contributing to recurrent events and a sustained burden.
The ABCstroke pathway, proposed by the ESC Council on Stroke, provides a structured and integrated framework for post-stroke care based on three core domains: appropriate antithrombotic therapy (A), better functional and psychological status (B), and cardiovascular risk factor and comorbidity optimisation (C).
While adherence to the ABCstroke pathway has been associated with improved clinical outcomes in observational cohorts, its economic value has not been previously assessed.
In a recent analysis published by the ESC Council on Stroke in European Heart Journal – Quality of Care and Clinical Outcomes, we evaluated the long-term cost-effectiveness of the ABCstroke pathway in the UK healthcare setting.
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 a 20-year horizon, patients receiving pathway-aligned care experienced both higher quality of life-adjusted survival (9.84 vs. 5.94 QALYs) and a lower incremental cost per QALY gained (£14,804), demonstrating that the ABCstroke pathway leads to better health outcomes and is cost-effective.
In conclusion, the ABCstroke pathway is cost-effective in the UK healthcare setting. Additional analyses in other healthcare settings are well in progress, and their findings may support its broader adoption and provide policymakers with further evidence for investing in structured, multidisciplinary secondary stroke prevention.
