Cost-Effectiveness of AF Screening With 2-Week Patch Monitors: The mSToPS Study.

Area of Science:

• Cardiology
• Health Economics
• Preventive Medicine

Background:

• The mSToPS study demonstrated that screening older Americans at risk for atrial fibrillation (AF) and stroke with 2-week patch monitors increased AF diagnosis and anticoagulant prescriptions.
• This screening approach improved clinical outcomes within 3 years compared to matched controls, but its cost-effectiveness was not previously evaluated.

Purpose of the Study:

• To conduct a health economic analysis of AF screening using 2-week patch monitors in older Americans.
• To evaluate the lifetime costs, survival, and quality-adjusted life years (QALYs) associated with this AF screening strategy.

Main Methods:

• A US-based health economic analysis utilized patient-level data from the mSToPS study.
• Clinical outcomes, resource use, and costs were tracked for 3 years using claims data.
• Lifetime costs, survival, and QALYs were projected using regression modeling and US life tables, with propensity score matching for group adjustment.

Main Results:

• The monitoring group incurred slightly higher total 3-year costs ($1551 more per person) but experienced fewer emergency visits and hospitalizations.
• Lifetime projections indicated slightly greater quality-adjusted survival in the monitoring group (0.09 QALYs).
• The incremental cost-effectiveness ratio was $36,100 per QALY gained, with 64% of bootstrap replicates falling below $50,000/QALY.

Conclusions:

• AF screening using 2-week patch monitors in older Americans demonstrates high economic value.
• The findings suggest this screening approach is a cost-effective strategy for preventing strokes.
• Further confirmation through a randomized trial is warranted to validate these economic findings.