Systematic review of societal costs associated with stroke, bleeding and monitoring in atrial fibrillation

J Comp Eff Res. 2019 Oct;8(14):1147-1166. doi: 10.2217/cer-2019-0089. Epub 2019 Aug 22.


Aim: Economic consequences associated with the rise in nonvitamin K antagonist oral anticoagulant use on a societal level remain unclear. Materials & methods: Evidence from the past decade on the societal economic burden associated with stroke, bleeding and international normalized ratio monitoring in atrial fibrillation was collected and summarized through a systematic literature review. Results: There were 14 studies identified that reported indirect costs, which were highest among patients with hemorrhagic stroke and intracranial hemorrhage. The contribution of indirect costs to the total was marginal during acute treatment but substantially increased (30-50%) 2 years after stroke and bleeding events. Conclusion: Limited data were available on societal costs in atrial fibrillation and further research is warranted.

Keywords: INR monitoring; atrial fibrillation; costs; indirect costs; major bleeding; stroke; systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Atrial Fibrillation / economics*
  • Cost of Illness*
  • Hemorrhage / economics*
  • Humans
  • Models, Econometric
  • Risk Factors
  • Stroke / economics*