Table 1 Characteristics of included studies and their economic evaluations
| Â | Labori et al. | Kawakami et al. | Reddy et al. | Reddy et al. | Ontario HTA series | Lee et al. | Reddy et al. | Freeman et al. | Saw et al. | Micieli et al. | Reddy et al. | Singh et al. |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Year of publication | 2022 | 2020 | 2019 | 2018 | 2017 | 2016 | 2016 | 2016 | 2016 | 2016 | 2015 | 2013 |
Study setting | Sweden | USA | USA | USA | Canada | USA | Germany | USA | Canada | Canada | USA | Canada |
Type of economic evaluation | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis | Cost-utility analysis |
Modeling technique used | combined decision tree and Morkov model | Markov model | Markov model | Markov model | Markov model | Markov model | Markov model | Markov model | Markov microsimulation model | Markov microsimulation model | Markov model | Markov microsimulation model |
Perspective | Swedish healthcare and public sector | US Health care provider | Health insurer | Health insurer | Ontario Ministry of Health and Long Term Care | Healthcare provider | German healthcare system | Health insurer | Healthcare provider | Healthcare provider | Health insurer | Healthcare provider |
Compared interventions | LAAC, standard care for AF patients with contraindications to OAC | LAAC following radio-ablation, novel OAC | LAAC, warfarin, novel OAC | LAAC, warfarin, dabigatran, rivaroxaban and apixaban | LAAC, warfarin, apixaban, dabigatran, rivaroxaban | LAAC, Aspirin, (Aspirin + clopidogrel), Warfarin, Dabigatran 110 mg, Dabigatran 150 mg, Apixaban, Rivaroxaban | LAAC, aspirin, apixaban | LAAC, warfarin, dabigatran | LAAC, aspirin | LAAC, warfarin, apixaban, dabigatran, rivaroxaban | LAAC, warfarin, novel OAC | LAAC, warfarin, dabigatran |
Base case population | 74-year-old patients with nonvalvular AF with contraindications to OAC | 65-year-old symptomatic AF patient planned for catheter ablation without contraindication for OAC | 70-year-old nonvalvular AF patient without contraindications to OAC | 70-year-old nonvalvular AF patient with a history of stroke | nonvalvular AF patients without contraindications for OAC | 65-year-old nonvalvular AF patient without any contraindication for anti-thrombotic therapy | 70-year-old AF patient with contraindications to warfarin | 70Â year old Nonvalvular AF patient with no contraindication to OAC | Nonvalvular AF patients at high risk of stroke and with contraindication to OAC | Patients with new onset AF presenting to emergency departments (mean age 68.9) without contraindication to OAC | 70-year-old nonvalvular AF without contraindication to OAC | Nonvalvular AF patients without contraindication for OAC |
Considered CHA2DS2VASc score a | 4 | 3 | 4 | 7 |  > 2 | Not specified | 3 |  > 1 |  > 2 | Not specified | 3.2 |  > 2 |
Considered/ mean HAS-BLED scoreb | Not specified | 3 | 1.98 | 3 | 0.8 | Not specified | 3 | Not specified | Not specified | Not specified | 2 | Â |
Measure of effect | QALY | QALY | QALY | QALY | QALY | QALY | QALY | QALY | QALY | QALY | QALY | QALY |
Currency type and year | Euro 2020 | USD 2020 | USD 2017 | USD 2016 | CAD 2016 | USD, year not specified | Euro 2014 | USD 2014 | CAD 2015 | CAD 2012 | USD 2015 | CAD 2012 |
Number of health states in the model | 11 | 11 | 16 | 16 | 10 | 11 | 16 | 12 | 6 | 10 | 14 | 10 |
Time horizon | Lifetime | 10Â years | Lifetime (20Â years) | Lifetime (20Â years) | Lifetime | 20Â years | 20Â years | Lifetime | Lifetime | Lifetime | Lifetime (20Â years) | Lifetime |
Cycle length | 1Â year | 1Â year | 3Â months | 3Â months | 1Â month | 1Â year | 3Â months | Not mentioned | 1Â month | 1Â month | 3Â months | 1Â month |
Annual discount rate for costs and outcomes | 3% | 3% | 3% | 3% | 3% | 3% | 3.50% | 3% | 5% | 5% | 3% | 5% |
Main limitation | How well secondary data matches the patient population in the model | Limitations of primary data | Limitations of primary data | Limitations of primary data | Unavailability of direct clinical evidence comparing LAAC with novel OAC | Limitations of primary data | Limitations of primary data | Limitations of primary data | Lack of standard accepted antithrombotic therapy post- LAAC | Limitations of primary data | Model allowed for only 1 clinical event per 3-month cycle | Limitations of primary data |
Funding source | None | None | LAAC manufacturing company | LAAC manufacturing company | Not specified | Not specified | LAAC manufacturing company | Government agencies | None | University sector | Not specified | Federal agency |
Conflicts of interest (COI) related to sponsorships by LAAC manufacturing companies | Having no COI declared | Having COI declared | Having COI declared | Having COI declared | Not specified | Having COI declared | Having COI declared | Having COI declared | Having COI declared | Having no COI declared | Having COI declared | Having no COI declared |