Early rhythm control strategy for AF may be cost-effective
Key takeaways:
- Early rhythm control was cost-effective vs. usual care in patients with atrial fibrillation in Germany.
- More research is needed about the cost-effectiveness of early rhythm control in other countries.
An early rhythm control strategy for treatment of atrial fibrillation was cost-effective in a German population, according to new data from the EAST-AFNET 4 trial.
“The health benefit of early rhythm control is evident. However, the cost-effectiveness of the new treatment strategy has not been evaluated so far,” Sophie Gottschalk, MSc, research fellow and PhD student in the department of health economics and health services research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Germany, said in a press release. “One concern after the publication of the EAST-AFNET 4 main study was whether the additional treatment would add an acceptable or undue financial burden to health care systems. In the current analysis, we examined for the first time the cost-effectiveness of early rhythm control compared to usual care.”
Image: Adobe Stock
As Healio previously reported, in the main results of EAST-AFNET 4, rhythm control therapy within 1 year of AF diagnosis in patients with CV conditions reduced the risk for CV events compared with usual care.
The analysis by Gottschalk and colleagues included 1,664 German patients from EAST-AFNET 4. The researchers compared costs (including hospitalization and medication) and effects (years survived and time to the primary outcome of CV death, hospitalization with worsening HF or ACS, or stroke) between the early rhythm control and usual care strategies over a 6-year time horizon from a German health care payer’s perspective.
Compared with the usual care strategy, the early rhythm control strategy was associated with higher costs (1,924 euros; 95% CI, –399 to 4,246).
The incremental cost-effectiveness ratio was 10,638 euros per additional year without a primary outcome and 22,536 euros per life-year gained, according to the researchers.
The probability of the early rhythm control strategy being cost-effective compared with usual care was 95% or greater per additional year without a primary outcome, and 80% or greater per additional life-year gained, at a willingness-to-pay value of at least 55,000 euros, Gottschalk and colleagues found.
“The health benefits of early rhythm control come at reasonable additional costs as indicated by our analysis of the EAST-AFNET 4 study data for Germany,” Paulus Kirchhof, MD, professor of cardiovascular medicine and director of the department of cardiology at University Heart and Vascular Center in Hamburg and professor of cardiovascular medicine at the University of Birmingham in the United Kingdom, said in the release. “The added cost is comparable to the cost of other therapies reducing outcomes, and within typical ranges of acceptable payments in Germany. Future studies examining the cost-effectiveness of early rhythm control in other countries, in subgroups with higher benefit from rhythm control therapy, or the cost-effectiveness of different modes of early rhythm control are warranted.”
Reference:
- European Society of Cardiology. www.escardio.org/The-ESC/Press-Office/Press-releases/is-early-rhythm-control-in-atrial-fibrillation-care-cost-effective. Published March 27, 2023. Accessed March 28, 2023.
Collapse
Read more about