OBJECTIVES: This study aimed to evaluate the economic and clinical benefits of the Watchman FLX Left Atrial Appendage Closure (LAAC) device for patients with non-valvular atrial fibrillation from the perspective of the Social Security Institution (SGK) in Turkiye.

METHODS: Cost-effectiveness analysis was employed to compare the Watchman FLX LAAC method with the standard non-vitamin K antagonist oral anticoagulant (NOAC) method. The analysis included direct costs and gained years of life as important outcome measures. All of the clinical data included in the Markov model were obtained from studies in the literature. The economic data of the study (costs of medicine, medical device, stroke, hospitalization, bleeding) were calculated according to SGK.

RESULTS: The results revealed that the average per-patient direct costs over a 10-year period were TRY139,272.23 for the Watchman FLX LAAC and TRY45,668.01 for the NOAC. The gained years of life were 9.02 years and 8.95 years, respectively. According to the calculations, it was calculated that the survival rates were approximately 80% in the NOAC treatment and 82% in the Watchman FLX LAAC application. The calculated incremental cost-effectiveness ratio (ICER) between the two methods was found to be TRY1,418,623.49. Gross domestic product (GDP) per capita, which was announced as TRY176,589 for 2022. Watchman FLX was found to be cost-effective, considering that the threshold value for rare diseases, as practiced in developed countries, can be up to 10 times the GDP per capita (TRY1.418.623<TRY1.765.890).

CONCLUSIONS: When taking into account the substantial clinical benefits and the perspective of SGK, the Watchman FLX LAAC device can be considered a cost-effective healthcare technology for the treatment of non-valvular atrial fibrillation patients in Turkiye.