The economic impact of potentially inappropriate medications in older stroke patients: a comparison of criteria

Background: Potentially inappropriate medications (PIMs) disproportionally affect the quality of life of patients aged 65 years or older and are associated with increased direct healthcare costs. However, evidence on their economic impact remains limited in the Vietnamese context. Objectives: To compare the potential costs associated with PIMs as measured using three tools (Beers, STOPP/START, and MALPIP), in elderly stroke patients. Methods: A descriptive cross-sectional study was conducted in 300 acute stroke patients aged 65 years and older receiving inpatient treatment at a hospital in Can Tho City, Vietnam, from January to July 2024. Results: The mean total direct healthcare cost per patient was VND 2,918,149. STOPP/START produced the highest estimated savings across all scenarios. Under the 100% discontinuation scenario, the total cost savings were VND 117,637 per patient per treatment episode, including VND 109,416 saved by the health insurance fund and VND 8,221 saved in patient out-of-pocket payments. Conclusion: The STOPP/START tool may better identify potentially avoidable medication-related costs. Healthcare professionals should consider integrating STOPP/START into routine medication reviews to help reduce unnecessary medication costs among older patients with stroke.