How do we calculate the costs of stroke care that go into our model?

CalculatorAndi Orlowski, Head of Business Intelligence, shares with us the work that took place behind the scenes when developing the AF Budget Impact Model.

“Recently I have been asked where the cost for stroke care comes from in our AF Budget Model and how it is aggregated (I am guessing so people can attribute savings across the system); so I thought I would share how we went about it and some alternative approaches we take, and you could take, to better understand these costs.

The great thing about our AF Budget Model is that it allows people and organisations to input their own figure so whether you follow either of the three I talk about below: Youman, Xu, the BHF or go your own way, you can input the figure that best represents your costs.

Youman et al¹

When we created the AF Budget Impact Model we used the cost for stroke from Youman et al as that was used by NICE in CG180. We have now updated those costs quoted in the paper to 2015-16 prices using the standard NHS HCHS inflators to yield an estimate of £12,228 for year 1 medical cost of strokes. One of the restrictions of the Youman model is that does not readily allow disaggregation into the sources of this expenditure.

Xu et al ²

An alternative analysis has been published since our AF model has been completed by Xu et al which yields a similar year 1 figure (£13,352). Using the reference below, you can explore how this figure is comprised.


A potential third source is the BHF cardiovascular disease statistics compendium. Table 4.1 below shows the overall distribution of NHS England spending on stroke care in 2013-14, although it should be borne in mind that this is not limited to the first year following a stroke. From here, we can work out the relative distribution of expenditure, which can then be applied to the costs shown in the AF model. This is necessarily an approximation, but it should give a reasonable guide to where the costs sit.

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¹. Youman P, Wilson K, Harraf F, Kalra L. The economic burden of stroke in the United Kingdom. Pharmacoeconomics. 2003;21 Suppl 1:43-50.

². Xu X-M, Vestesson E, Paley L, Desikan A, Wonderling D, Hoffman A, et al. The economic burden of stroke care in England, Wales and Northern Ireland: Using a national stroke register to estimate and report patient-level health economic outcomes in stroke. European Stroke Journal.0(0):2396987317746516.