Bibliographic Details
| Title: |
An economic evaluation of first-line cryoballoon ablation versus antiarrhythmic drug therapy for the treatment of paroxysmal atrial fibrillation from a German healthcare payer perspective |
| Authors: |
Malte Kuniss, Lucy Hillcoat, Joe Moss, Florian Straube, Jason Andrade, Oussama Wazni, Gian Battista Chierchia, Lukas Schwegmann, Eleni Ismyrloglou, Alicia Sale, Stuart Mealing, Tom Bromilow, Emily Lane, Damian Lewis, Andreas Goette |
| Source: |
BMC Health Services Research, Vol 24, Iss 1, Pp 1-13 (2024) |
| Publisher Information: |
BMC, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Public aspects of medicine |
| Subject Terms: |
Ablation, Cryoablation, Cost-effectiveness, Paroxysmal atrial fibrillation, Antiarrhythmic drug, Public aspects of medicine, RA1-1270 |
| More Details: |
Abstract Background Three recent randomized controlled trials demonstrated that, in patients with symptomatic paroxysmal atrial fibrillation (PAF), first-line pulmonary vein isolation with cryoballoon catheter ablation reduces atrial arrhythmia recurrence compared to initial antiarrhythmic drug (AAD) therapy. This study aimed to evaluate the cost-effectiveness of first-line cryoablation compared to first-line AADs from a German healthcare payer perspective. Methods Individual patient-level data from 703 participants with untreated PAF enrolled into three randomized clinical trials (Cryo-FIRST, STOP AF First and EARLY-AF) were used to derive parameters for the cost-effectiveness model (CEM). The CEM structure consisted of a hybrid decision tree and Markov model. The decision tree (one-year time horizon) informed initial health state allocation in the first cycle of the Markov model (40-year time horizon; three-month cycle length). Health benefits were expressed in quality-adjusted life years (QALYs). Cost inputs were sourced from German diagnosis-related groups and the Institute for the Hospital Remuneration System (InEK). Costs and benefits were discounted at 3% per annum. Results Cryoablation was cost-effective, incurring ~ €200 per patient while offering an increase in QALYs (~ 0.18) over a lifetime. This produced an average incremental cost-effectiveness ratio of ~ €1,000 per QALY gained. Individuals were expected to receive ~ 1.2 ablations over a lifetime, regardless of initial treatment. However, those initially treated with cryoablation as opposed to AADs experience 0.9 fewer re-ablations and a 45% reduction in time spent in AF health states. Conclusion Initial rhythm control with cryoballoon ablation in symptomatic PAF is a cost-effective treatment option in a German healthcare setting. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
1472-6963 |
| Relation: |
https://doaj.org/toc/1472-6963 |
| DOI: |
10.1186/s12913-024-11967-0 |
| Access URL: |
https://doaj.org/article/4766e7497ae84ae7b3a3a48fa0750b7f |
| Accession Number: |
edsdoj.4766e7497ae84ae7b3a3a48fa0750b7f |
| Database: |
Directory of Open Access Journals |
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