Cost-Effectiveness of Atrial Fibrillation Screening Programmes Across European Nations

BACKGROUND AND AIMS: Due to the aging population in Europe, a significant increase in the incidence of atrial fibrillation (AF) is anticipated. This is predicted to have a detrimental impact on public health costs, particularly among the elderly, because of an increased number of stroke cases. Early detection of AF is crucial for initiating treatment with oral anticoagulants (OACs) to reduce the risk of stroke. This study aims to assess the cost-effectiveness of implementing AF-screening programmes in eight European countries: Denmark, Germany, Ireland, Italy, the Netherlands, Serbia, Spain and Sweden.

METHODS: The analysis concerned invitation to AF population screening for 75-year-olds. A Markov cohort model was used, considering the prevalence of AF, screening yield, the use of different OACs, estimated clinical events, mortality, quality of life and costs. The model used country-specific parameters to produce specific cost-effectiveness estimates. Probabilistic sensitivity analyses were conducted to assess the impact of parametric uncertainties on the results.

RESULTS: Inviting 75-year-olds to AF-screening proved to be cost-effective across all eight countries analysed. In all countries, the strategy was dominant, meaning that quality-adjusted life-years were gained at lower costs. The time to financial break-even ranged from 6 to 14 years.

CONCLUSIONS: This study indicates that population-based AF-screening of 75-year-olds is a cost-effective strategy across eight European countries, meaning that adoption of such a strategy has the potential to make healthcare systems in these countries more efficient. The heterogeneity among European countries suggests that AF-screening programmes may need to be tailored to the specific healthcare systems and conditions of each nation.