Budget impacts associated with improving diagnosis and treatment of atrial fibrillation in high-risk stroke patients.

Estimate the 3-year budget impact in England from 2016/17 of improving nonvalvular atrial fibrillation management in high-risk stroke patients. The Academic Health Science Network's AF Business Case Model was used to identify detection, protection (risk assessment and treatment initiation) and perfection (optimized treatment) gaps and to project the budget impact of closing these. Closing all gaps over 3 years could prevent 27,550 strokes. Overall, perfection gap savings were £136,650,962 and protection gap savings were £58,146,171. Detection by screening in year one could cost £149,048,676, but with stroke-prevention savings would be £47,081,047 at 3 years. Thus, total potential savings were £194,797,133 and the cost-adjusted budget impact was £147,716,086. The detection and perfection gaps are key areas for investment.