Cost-Effectiveness of Anticoagulation Treatment for Subclinical Device-Detected Atrial Fibrillation

Is anticoagulation for stroke prevention in patients with device-detected atrial fibrillation cost-effective?In this economic evaluation with a simulated cohort of 20 000 individuals, treatment with direct oral anticoagulants resulted in an additional 0.016 quality-adjusted life-years at an incremental cost of €1676 per patient over a 10-year simulation, corresponding to an incremental cost-effectiveness ratio of €105 293 per quality-adjusted life-year. The probability of cost-effectiveness was 35%, while there was a 38% probability of both lower quality-adjusted life-years and higher costs.The findings of this study suggest that routine anticoagulation in all patients with device-detected atrial fibrillation may not be cost-effective and may represent low-value care.

Corresponding Author: Konsta Teppo, MD, PhD, Kiinanmyllynkatu 20, University of Turku, 20520, Turku, Finland (jkitep@utu.fi).

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