A study comparing the stroke risk for atrial fibrillation patients treated with Boston Scientific‘s (NYSE:BSX) Watchman device with the anticoagulant drug warfarin and non-warfarin oral anticoagulants found Watchman to be more cost-effective than its counterparts.
Watchman is a catheter-delivered cardiac implant designed to close off the left atrial appendage, to prevent blood clots from forming there that could later cause a stroke.
The study, published online in the Journal of the American College of Cardiology, showed that the Watchman device was cost-effective at 7 years at a cost of $42,994 per quality-adjusted life-years, compared with warfarin ($48,446 per QALY)); NOACs were cost-effective at 16 years.
Left atrial appendage closure was “dominant” over NOACs by year 5 and warfarin by year 10, according to the study.
“At 10 years, LAAC provided more QALYs than warfarin and NOACs (5.855 vs. 5.601 vs. 5.751, respectively). In sensitivity analyses, LAAC remained cost-effective relative to warfarin ($41,470/QALY at 11 years) and NOACs ($21,964/QALY at 10 years), even if procedure costs were doubled,” the authors wrote.
“Both NOACs and LAAC with the Watchman device were cost-effective relative to warfarin, but LAAC was also found to be cost-effective and to offer better value relative to NOACs. The results of this analysis should be considered when formulating policy and practice guidelines for stroke prevention in AF,” they wrote.
The study could help Boston Scientific in its quest to win a favorable coverage decision from the Centers for Medicare & Medicaid Services, which last month proposed to limit coverage to patients at high risk for stroke and bleeding and/or contraindicated to long-term warfarin use.