by Anuj Shah, Anand Shewale, Corey J. Hayes, and Bradley C. Martin

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by Anuj Shah, Anand Shewale, Corey J. Hayes, and Bradley C. Martin Cost-Effectiveness of Oral Anticoagulants for Ischemic Stroke Prophylaxis Among Nonvalvular Atrial Fibrillation Patients by Anuj Shah, Anand Shewale, Corey J. Hayes, and Bradley C. Martin Stroke Volume 47(6):1555-1561 May 23, 2016 Copyright © American Heart Association, Inc. All rights reserved.

Schematic representation of Markov model. Schematic representation of Markov model. All patients with atrial fibrillation (AF) and increased stroke risk (CHADS2 score ≥1; congestive heart failure [1 point], hypertension [1 point], age ≥75 years [1 point], diabetes mellitus [1 point], stroke [2 points]) enter the model at varying ages depending on the age distribution of a commercially insured incident AF population. The cycle length is 30 d, and the model is terminated when 99% of the cohort dies. The transition probabilities into various health states depends on the prescribed therapy. *All patients start on an anticoagulant in well state but switch to aspirin in well state after an extracranial hemorrhage (ECH). †Myocardial infarction and ECH are temporary health states. ICH indicates intracranial hemorrhage; and RIND, reversible ischemic neurological damage. Anuj Shah et al. Stroke. 2016;47:1555-1561 Copyright © American Heart Association, Inc. All rights reserved.

Cost-effectiveness (CE) acceptability curve (probability that a treatment will be cost-effective at varying willingness-to-pay thresholds). Cost-effectiveness (CE) acceptability curve (probability that a treatment will be cost-effective at varying willingness-to-pay thresholds). The percentage of iterations that showed the particular therapy to be CE are plotted on the y-axis vs varying willingness to pay thresholds (plotted in terms of dollars a payer is willing to pay to achieve an additional quality-adjusted life-year for a patient) on the x-axis. A, Depicts the CE acceptability curve for the base case scenario. B, The CE acceptability curve after inflating the standard deviations of the efficacy measures for the newer oral anticoagulants by 50%. Anuj Shah et al. Stroke. 2016;47:1555-1561 Copyright © American Heart Association, Inc. All rights reserved.