From: Cost-effectiveness of an insertable cardiac monitor in a high-risk population in the US
Scenario description | ICER per QALY | ||
---|---|---|---|
Incremental cost | Incremental QALYs | ICM versus SoC | |
Base case | $5786 | 0.16 | $35,528 |
Sub-group analyses* | |||
CHADS2 score 2 | $6409 | 0.12 | $55,059 |
CHADS2 score 3 | $5867 | 0.16 | $37,118 |
CHADS2 score 4, 5, and 6 | $5792 | 0.13 | $43,803 |
Scenario analyses | |||
Choice of NOAC = warfarin | $5950 | 0.11 | $56,916 |
Cost of aspirin = $0 | $5917 | 0.16 | $36,328 |
Treatment discontinuation for reasons other than bleeding = 0% | $4933 | 0.31 | $15,843 |
ICM battery life 4.5Â years | $5777 | 0.17 | $33,229 |
ICM battery life 4.5Â years, assume linear extrapolation | $5786 | 0.20 | $27,986 |
ICM battery life 4.5Â years, assume no AF after 30-month trial data | $5806 | 0.16 | $37,594 |
Monitoring costs for SoC: assume pulse check and HR of ICM versus SoC is 1/24th of the Holter monitoring (scenario proposed by clinical experts) | $6954 | 0.17 | $40,992 |
Assume SoC consists of one 24-Holter in the first cycle | $6773 | 0.17 | $31,116 |
AF episode duration lasting for ≥ 5.5 h†| $6713 | 0.08 | $86,013 |
NOAC uptake after AF diagnosis = 66.35% | $6301 | 0.12 | $54,368 |
Time horizon = 5 years | $6433 | 0.02 | $261,147 |
Time horizon = 10 years | $5797 | 0.08 | $75,047 |
Time horizon = 25 years | $5776 | 0.16 | $35,771 |
Heart failure subgroup base case | $6236 | 0.19 | $33,273 |
Scenarios | |||
Choice of NOAC = warfarin | $6384 | 0.13 | $50,659 |
ICM battery life 4.5Â years | $6193 | 0.20 | $30,777 |
ICM battery life 4.5Â years, assume linear extrapolation | $5837 | 0.28 | $20,967 |
ICM battery life 4.5Â years, assume no AF after 2-year trial data | $6508 | 0.19 | $34,332 |