Supplementary tables: Clinical and economic outcomes associated with use of anti-arrhythmic drugs versus ablation in atrial fibrillation

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posted on 2024-04-15, 13:35 authored by Jennifer Ken-Opurum, Sesha Srinivas, Seojin Park, Scott Charland, Andrew Revel, Ronald Preblick

These are peer-reviewed supplementary data for the article 'Clinical and economic outcomes associated with use of anti-arrhythmic drugs versus ablation in atrial fibrillation' published in the Journal of Comparative Effectiveness Research.

Supplementary table 1: Risk of occurrence of LTCO in direct comparison of individual drugs scenario
Supplementary table 2: LTCO risk of treatments (non-temporal scenarios)
Supplementary table 3: LTCO risk of treatments (temporal scenarios)

Aim: To evaluate the clinical and economic impact of antiarrhythmic drugs (AADs) compared with ablation both as individual treatments and as combination therapy without/with considering the order of treatment among patients with atrial fibrillation (AFib). Materials & methods: A budget impact model over a one-year time horizon was developed to assess the economic impact of AADs (amiodarone, dofetilide, dronedarone, flecainide, propafenone, sotalol, and as a group) versus ablation across three scenarios: direct comparisons of individual treatments, non-temporal combinations, and temporal combinations. The economic analysis was conducted in accordance with CHEERS guidance as per current model objectives. Results are reported as costs per patient per year (PPPY). The impact of individual parameters was evaluated using one-way sensitivity analysis (OWSA). Results: In direct comparisons, ablation had the highest annualmedication/procedure cost ($29,432), followed by dofetilide ($7661), dronedarone ($6451), sotalol ($4552), propafenone ($3044), flecainide ($2563), and amiodarone ($2538). lecainide had the highest costs for long-term clinical outcomes ($22,964), followed by dofetilide ($17,462), sotalol ($15,030), amiodarone ($12,450), dronedarone ($10,424), propafenone ($7678) and ablation ($9948). In the non-temporal scenario, total costs incurred for AADs (group) + ablation ($17,278) were lower compared with ablation alone ($39,380). In the temporal scenario, AADs (group) before ablation resulted in PPPY cost savings of ($22,858) compared with AADs (group) after ablation ($19,958). Key factors in OWSA were ablation costs, the proportion of patients having reablation, and withdrawal due to adverse events. Conclusion: Utilization of AADs as individual treatment or in combination with