Table 3: One-way sensitivity analyses, PIAAF-Pharmacy screening versus no screening (base case: incremental cost per QALY gained = $1175).
Variable | Incremental cost, $ | Incremental no. of QALYs | Incremental cost/QALY gained, $ |
---|---|---|---|
Cost of screening, $ (base case = $65) | |||
100 | 60 | 0.0035 | 17 195 |
90 | 50 | 0.0035 | 14 325 |
80 | 40 | 0.0035 | 11 455 |
70 | 30 | 0.0035 | 8585 |
60 | 20 | 0.0035 | 5715 |
50 | 10 | 0.0035 | 2845 |
40 | -0 | 0.0035 | Dominates |
30 | -10 | 0.0035 | Dominates |
% of people with newly diagnosed atrial fibrillation who receive oral anticoagulant therapy (base case = 0.71) | |||
1.0 | 10 | 0.0049 | 2056 |
0.9 | 16 | 0.0044 | 3562 |
0.8 | 21 | 0.0039 | 5446 |
0.7 | 27 | 0.0034 | 7867 |
0.6 | 32 | 0.0029 | 11 096 |
0.5 | 38 | 0.0024 | 15 616 |
0.4 | 44 | 0.0020 | 22 397 |
0.3 | 49 | 0.0015 | 33 697 |
0.2 | 55 | 0.0010 | 56 298 |
0.1 | 61 | 0.0005 | 124 101 |
Positive predictive value of single-lead electrocardiography (base case = 0.654) | |||
1.0 | 5 | 0.0053 | 911 |
0.9 | 11 | 0.0048 | 2291 |
0.8 | 17 | 0.0043 | 4015 |
0.7 | 23 | 0.0037 | 6232 |
0.6 | 29 | 0.0032 | 9189 |
0.5 | 36 | 0.0027 | 13 327 |
0.4 | 42 | 0.0021 | 19 535 |
0.3 | 48 | 0.0016 | 29 882 |
0.2 | 54 | 0.0011 | 50 575 |
0.1 | 60 | 0.0005 | 112 656 |
% of people with undiagnosed atrial fibrillation in whom the disorder is diagnosed each year (base case = 0.03) | |||
0 | 20 | 0.0040 | 4951 |
0.05 | 30 | 0.0032 | 9215 |
0.1 | 36 | 0.0027 | 13 724 |
0.2 | 45 | 0.0019 | 23 499 |
0.3 | 50 | 0.0015 | 34 355 |
0.4 | 53 | 0.0011 | 46 475 |
0.5 | 56 | 0.0009 | 60 186 |
Time horizon, yr (base case = lifetime) | |||
5 | 36 | 0.0010 | 37 226 |
10 | 25 | 0.0023 | 10 657 |
15 | 25 | 0.0031 | 7800 |
20 | 26 | 0.0034 | 7490 |
25 | 26 | 0.0035 | 7480 |
Annual rate of discontinuation of oral anticoagulant therapy (base case = 10%) | |||
0 | 1 | 0.005 | 232 |
0.1 | 26 | 0.003 | 7480 |
0.2 | 38 | 0.002 | 15 480 |
0.3 | 45 | 0.002 | 24 333 |
0.4 | 50 | 0.001 | 34 208 |
0.5 | 53 | 0.001 | 45 382 |
Alternative stroke costs | 46 | 0.003 | 13 277 |
Warfarin represents 100% of orally administered anticoagulants* | 17 | 0.003 | 5985 |
Direct oral anticoagulant therapy represents 100% of orally administered anticoagulants† | 36 | 0.004 | 8611 |
Note: PIAAF-Pharmacy = Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting, QALY = quality-adjusted life-year.
*Base case: 52%.
†Base case: 48%.