Table 5:

Results of Economic Literature Review—Patients With Nonvalvular Atrial Fibrillation With Contraindications to Oral Anticoagulants

Author, Year, Location	Study Design and Perspective	Population/Comparator	Interventions	Results
				Health Outcomes	Costs	Cost-Effectiveness	Probability LAAC Is Cost-Effective (WTP Threshold)
Reddy et al, 2016, Germany32	Markov cohort model German health care system perspective 20-year model	Patients with NVAF and contraindications to warfarin CHA2DS2VASc (mean) = 3 HAS-BLED (mean) = 3 Age = 70 years	LAAC device Aspirin Apixaban	LAAC device = 4.82 QALYs/person Aspirin = 4.21 QALYs/person Apixaban = 4.59 QALYs/person 3.5% discount rate	LAAC device = €15837/person Aspirin = €21077/person Apixaban = €18869/person 3.5% discount rate, EUR	Dominant vs. aspirin Dominant vs. apixaban	vs. aspirin: 99% (€30,000/QALY) vs. apixaban: 94% (€30,000/QALY)
Saw et al, 2016, Canada36	Markov microsimulation Ontario Ministry of Health and Long-Term Care perspective Lifetime model	Patients with NVAF and contraindications to OACs	LAAC device Aspirin	LAAC device = 4.66 QALYs/person Aspirin = 4.25 QALYs/person 5% discount rate	LAAC device = $30,748/person Aspirin = $38,974/person 5% discount rate	Dominant vs. aspirin	vs. aspirin: > 90% (€30,000/QALY)

Abbreviations: CHADS₂DS₂VASc, Congestive heart failure, Hypertension, Age ≥ 75 years (2 points), Diabetes mellitus, Stroke or transient ischemic attack symptoms previously (2 points), Vascular disease, Age 65–74 years, Sex category; HAS-BLED, Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile international normalized ratios (INRs), Elderly, Drugs or alcohol; LAAC device, left atrial appendage closure device with delivery system; NOAC, novel oral anticoagulant; NVAF, nonvalvular atrial fibrillation; OAC, oral anticoagulant; QALY, quality-adjusted life-year; WTP, willingness to pay.