Abstract 11651: Cost-effectiveness of Screening for Atrial Fibrillation in Primary Care With a Hand-held, Single-lead ECG Device in the Netherlands
Introduction: Atrial fibrillation (AF) is the most common arrhythmia and prevalence increases with age. Patients with AF have a high risk of stroke and screening for AF is recommended in all people aged 65 years or older to identify patients eligible for stroke prevention. A hand-held, single-lead ECG device can be used for systematic screening in the population at risk. The objective of this study is to estimate the cost-effectiveness of screening for atrial fibrillation in primary care with the MyDiagnostick® during seasonal influenza vaccination in the Netherlands.
Methods: Life-time costs and effects of a single screening session for AF detection were assessed from a societal perspective with a decision analytic model consisting of a straightforward decision tree and a joining Markov model. The decision model simulated all patients aged 65 years and over attending the seasonal influenza vaccination in the Netherlands. Event probabilities were derived from clinical trials. Sensitivity analyses were performed to assess the impact of important model assumptions as well as determining the relative effect of individual parameters.
Results: Screening for AF with the MyDiagnostick® in all patients older than 65 years that attend seasonal influenza vaccination in the Netherlands would decrease the overall costs by є1,364 and increase the quality-adjusted life years (QALYs) by 0.45 QALYs per patient. Early detection of AF would prevent strokes and leads to beneficial health-effects with subsequent cost savings. This screening method would have an estimated probability of 99.9% for being cost-effective at a conservative willingness-to-pay of є20,000/QALY gained.
Conclusions: Screening for AF in primary care with a hand-held, single-lead ECG during seasonal influenza vaccination is very likely to be cost saving for identifying new cases of AF in the Dutch population aged 65 years and over. Active screening for AF with a single-lead, hand-held ECG device during seasonal influenza vaccination should be implemented in primary care.
Author Disclosures: M. Jacobs: None. F. Kaasenbrood: None. M. Postma: Honoraria; Modest; received grants and honoraria from various pharmaceutical companies, inclusive those developing, producing and marketing new oral anticoagulants (NOACs). None related to this study. M. Van Hulst: Research Grant; Modest; reports grants from Bayer and personal fees from Boehringer Ingelheim during the conduct of the study and not related to this study. R. Tieleman: Research Grant; Modest; reports grants and personal fees from Boehringer Ingelheim, personal fees from Bayer and personal fees from Pfizer/ Bristol Meyer Squibb all outside the submitted work.. Ownership Interest; Significant; co-inventor of the MyDiagnostick and receives royalties from Applied Biomedical Systems (ABS)..
- © 2016 by American Heart Association, Inc.