Shahriar Ghashghaei
Maryam Alsadat Mousavi
Shahedeh Karimi
Seyed Sam Nadali Pour
Seyed Massood Nabavi
Massoud Vosough

Stroke, is accounting for more than ۳۴% of total healthcare spending globally. Ischemic stroke (IS) accounts for ۶۲.۴% of incident stroke cases. IS-related direct medical expenditures place a considerable burden on healthcare system. The burden is more prominent in developing countries where limitations in insurance coverage is a big concern. It would be less challenging in developed countries, where costs are covered by third parties. After introduction of advanced therapeutic medicinal products (ATMPs), a new line of treatments is proposed. Although the high prices of these treatments may cause financial concerns, they have encouraged scientists and provided acceptable results in a way that makes investment in this area reasonable for health experts. All ATMP-based therapies used in clinical trials for the treatment of IS are stem-cell-based or stem-cell-derivatives. The cost of stem-cell-based therapies are considerable like other alternative medical settings, e.g., thrombolysis and thrombectomy. However, the considerable recovery after prescription of ATMPs is expected to be cost-effective. Furthermore, various gene therapy approaches for the treatment of IS have been proposed. However, none has been qualified for clinical studies yet. If such a procedure is introduced in near future, it does not necessarily guarantee that these innovative treatments would be offered to the patients.   Application of ATMPs have many challenges particularly in developing countries. This is primarily related to exorbitant expenditures. Despite these challenges, the insurance systems in developed-countries supports stem-cell therapies as novel treatments. Significant improvements in the insurance systems of both developing and developed countries are necessary.  

Advanced therapeutic medicinal products (ATMPs), Ischemic stroke, Insurance systems, Developing countries