Health economic analysis finds benefit to AF screening with Zio XT ambulatory patch


iRhythm Technologies has announced a new health economic analysis of the mSToPS study, presented at the American Heart Association (AHA) scientific sessions 2022 (5–7 November, Chicago, USA).

The study evaluated the cost-effectiveness of screening for atrial fibrillation (AF) with Zio XT, an ambulatory cardiac monitor supported by deep learning algorithms. The analysis found that systematic screening for AF in an at-risk population with the iRhythm Zio XT patch provided high value from a health economic perspective.

Over three years, individuals prescribed Zio XT were more likely than unmonitored individuals to have outpatient visits—including to cardiologists—but less likely to require emergency department visits or hospitalisation.

In patient-level projections, the group prescribed Zio XT had slightly better total and quality-adjusted survival (11.91 vs. 11.82 life years, 9.38 vs. 9.30 years). The study demonstrated an incremental cost-effectiveness ratio (ICER) of US$17,000 per quality-adjusted life year gained, which is the academic standard for measuring how well medical treatments lengthen and/or improve patients’ lives. The ICER is substantially lower than accepted willingness-to-pay thresholds in the USA and other healthcare systems. The authors concluded that screening for AF using Zio XT provided high value from a health economic perspective.

“mSToPS is the first study to observe the benefits of AF screening at three years—which translates to a small but meaningful gain in quality-adjusted life expectancy with a nominal (<1%) increase in lifetime healthcare spending—and the first to complete a formal health economic analysis. We conclude that AF screening with Zio monitors is likely to both benefit older Americans and provide excellent value to the healthcare system by enabling early diagnosis,” said Matthew R Reynolds (Lahey Hospital & Medical Center, Burlington, USA).

mSToPS was a direct-to-participant randomised clinical trial combined with a prospective matched observational cohort study. The study, published in the Journal of the American Medical Association (JAMA) in 2018 found that Zio XT-based screening was associated with increased detection of AF, greater use of outpatient cardiology care, and a higher rate of initiation of stroke prevention therapy. A three-year follow-up analysis of the mSToPS study, published in PLOS One in 2021, found that screening with Zio XT was associated with a lower rate of clinical events and improved outcomes relative to a matched cohort.

“Taken together, these studies demonstrate screening for AF in at-risk populations can lead to positive patient health outcomes, especially when coupled to appropriate therapy, including stroke prevention, rhythm control, and risk factor modification,” commented Mintu Turakhia, chief medical officer and chief scientific officer at iRhythm. “These studies are not in isolation and build upon a strong body of evidence from randomized trials including STROKE-STOP, EAST-AFNET 4, and others. This is precisely why we have launched Know Your Rhythm, our risk-sharing program where we partner with healthcare systems to evaluate for undiagnosed AF and other arrhythmias and link this to evidence-based initiation of treatment.”


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