Table 3.
Cost and utilities of interventions, events and health states
| Event, intervention or health state | Mean cost (£) | SE (£) | Mean utility | SE | Source |
| Stroke and bleed events* | |||||
| Mild IS | 3783 | 997 | 0.730 | 0.014 | Luengo-Fernandez et al (2013a,b) 19 20† |
| Moderate IS | 19 737 | 2451 | 0.500 | 0.037 | |
| Severe IS | 26 957 | 3947 | 0.130 | 0.057 | |
| Fatal IS | 3403 | 551 | 0.000 | – | |
| Mild HS | 11 016 | 2017 | 0.730 | 0.014 | |
| Moderate HS | 28 301 | 5563 | 0.500 | 0.037 | |
| Severe HS | 47 872 | 12 911 | 0.130 | 0.057 | |
| Fatal HS | 1771 | 667 | 0.000 | – | |
| Disutility for all recurrent (secondary) stroke events (acute period) | – | −0.150 | 0.039 | Luengo-Fernandez et al (2013a)19 | |
| Other events | |||||
| Other ICH | 2880 | 440 | 0.700 | 0.093 | Luengo-Fernandez et al (2013a,b) and Department of Health (2017)19–21 |
| Cost and disutility of CRNM | 473 | 70 | −0.058 | 0.017 | |
| Cost and disutility of GI bleed | 856 | 70 | −0.151 | 0.040 | |
| Cost and disutility of other ECH | 2118 | 117 | −0.151 | 0.040 | |
| Infection (related to ICM) | 757 | 297 | – | Department of Health (2017)21 | |
| Health states before any event | |||||
| Starting utility and No-AF | – | 0.820 | 0.008 | Data on file, Medtronic 2018 | |
| Disutility for presence of AF | – | −0.014 | 0.019 | Luengo-Fernandez et al (2013a)19 | |
| Post-stroke health states (per cycle) | |||||
| Postmild stroke (IS or HS) | 594 | 452 | 0.727 | 0.012 | Luengo-Fernandez et al (2013a,b)19 20‡ |
| Post-moderate stroke (IS or HS) | 1158 | 1007 | 0.582 | 0.035 | |
| Post-severe stroke (IS or HS) | 1759 | 0.397 | 0.065 | ||
| Disutility for recurrent (secondary) stroke (post-acute period) | – | −0.068 | 0.024 | Luengo-Fernandez et al (2013a,b)19 20 | |
| One-time intervention costs | |||||
| ICM acquisition and insertion | 1426 | 1129 | – | Department of Health (2017)21 | |
| ICM removal | 757 | 297 | – | Department of Health (2017)21 | |
| Monitoring and follow-up (per cycle) | |||||
| ICM | 26.75 | – | Department of Health (2017)21 | ||
| 24 hours Holter monitoring | 37.88 | – | Department of Health (2013)32† | ||
| Drug costs (per cycle) | |||||
| Aspirin | 6.02 | – | MIMS (2018)33 | ||
| Warfarin | 5.71 | – | MIMS (2018)33 | ||
| Warfarin INR monitoring | 66.60 | – | Dorian et al (2014)14 and Lip et al (2014)15§ | ||
| NOAC* | 159.43 | – | MIMS (2018)33 | ||
*NOAC drug cost was assumed to be the average of dabigatran, rivaroxaban, apixaban, and edoxaban
†Unit costs were inflated from 2013 to 2016/2017 values.
‡Unit costs were inflated from 2008/2009 to 2016/2017 values.
§Unit costs were inflated from 2014 to 2016/2017.
AF, atrial fibrillation;ECH, extracranial haemorrhage;GI, gastrointestinal;HS, haemorrhagic stroke;ICH, intracranial haemorrhage;ICM, insertable cardiac monitor;INR, international normalised ratio;IS, ischaemic stroke; NOAC, new oral anticoagulant; SoC, standard of care.