The budget impact of implementing atrial fibrillation-screening in European countries.

A budget impact analysis estimates the short-term difference between the cost of the current treatment strategy and a new treatment strategy, in this case to implement population screening for atrial fibrillation (AF). The aim of this study is to estimate the financial impact of implementing population-based AF-screening of 75-year-olds compared with the current setting of no screening from a healthcare payer perspective in eight European countries. The net budget impact of AF-screening was estimated in country-specific settings for Denmark, Germany, Ireland, Italy, Netherlands, Serbia, Spain, and Sweden. Country-specific parameters were used to allow for variations in healthcare systems and to reflect the healthcare sector in the country of interest. Similar results can be seen in all countries AF-screening incurs savings of stroke-related costs since AF treatment reduces the number of strokes. However, the increased number of detected AF and higher drug acquisition will increase the drug costs as well as the costs of physician- and control visits. The net budget impact per invited varied from €10 in Ireland to €122 in the Netherlands. The results showed the increased costs of implementing AF-screening were mainly driven by increased drug costs and screening costs. In conclusion, across Europe, though the initial cost of screening and more frequent use of oral anti-coagulants will increase the healthcare payers' costs, introducing population screening for AF will result in savings of stroke-related costs.

© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.

Conflict of interest: M.E., J.L., L.B., and K.A. report no conflicts of interest. L.Å.L. has received lecture fees and advisory board fees from BMS/Pfizer, Bayer, Boehringer Ingelheim, and Zenicor and own stocks in Astra Zeneca. J.H.S. reports to be a member of Medtronic and Vital Beats advisory boards and to have received speaker honoraria and research grants from Medtronic. R.B.S. has received lecture fees and advisory board fees from BMS/Pfizer and Bayer outside this work. D.E. reports no conflicts of interest. C.M. and C.W. are employees of the Institute for Epidemiology, Statistics and Informatics GmbH. The Institute for Epidemiology, Statistics and Informatics GmbH has received grants from Astra Zeneca, Bayer, Bristol-Myers Squibb and CSL Behring outside the submitted work. S.Z.D. reports consultancy fees from VitalBeats, BMS/Pfizer, Cortrium, and Acesion Pharma, speaker grants from BMS/Pfizer and Bayer, and travel grants from Abbott and Boston Scientific. G.B. reports speaker’s fees of small amount from Bayer, Boehringer Ingelheim, Boston, Daiichi Sankyo, Janssen, and Sanofi outside of the submitted work. C.M.B. reports no conflicts of interest.