Cost-effectiveness analysis of left atrial appendage occlusion compared with pharmacological strategies for stroke prevention in atrial fibrillation

Table 3 Lifetime results of total Costs, total QALYs and ICERs for each stroke prevention strategy (start age at 65-year-old patients)

Therapy	Total Discounted Costs, USD	Total Discounted QALYs, Year	Cost per QALY	ICER, vs. Aspirin	ICER, vs. Clopidogrel plus Aspirin	ICER, vs. Warfarin	ICER, vs. LAA Occlusion	ICER, vs. Dabigatran 110 mg	ICER, vs. Dabigatran 150 mg	ICER, vs. Rivaroxaban	ICER, vs. Apixaban	ICER, vs. Next-best strategy
Aspirin	$12,877	6 · 12	$2,104	---	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Dominated^a	---
Clopidogrel plus aspirin	$26,287	6 · 29	$4,179	$78,882	---	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Dominated^a	Extended dominance
Warfarin	$28,090	9 · 45	$2,972	$4,568	$571	---	Dominated^a	Dominated^b	Dominated^b	Dominated^a	Dominated^b	$571
LAA Occlusion	$37,789	10.99	$3,438	$5,115	$2,447	$6,298	---	Dominated^b	Dominated^b	Dominated^b	Dominated^b	$6,298
Dabigatran 110 mg	$42,712	8.76	$4,876	$11,301	$6,650	Dominated^c	Dominated^c	---	Dominated^a	Dominated^a	Dominated^a	Dominated^a
Dabigatran 150 mg	$43,946	9.00	$4,883	$10,788	$6,516	Dominated^c	Dominated^c	$5,142	---	Dominated^a	Dominated^a	Dominated^a
Rivaroxaban	$51,064	9.86	$5,179	$10,210	$6,940	$56,034	Dominated^c	$7,593	$8,277	---	Dominated^a	Dominated^a
Apixaban	$53,315	9.40	$5,672	$12,329	$8,691	Dominated^c	Dominated^c	$16,567	$23,423	Dominated^c	---	Dominated^a

Abbreviations: LAA left atrial appendage, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life year, Extended dominance the alternative has a higher ICER than a more effective comparator
^aLess costly and less effective strategy
^bLess costly but more effective strategy
^cMore costly but less effective strategy

ISSN: 1471-2261