A danish healthcare-focused economic evaluation of first-line cryoballoon ablation versus antiarrhythmic drug therapy for the treatment of paroxysmal atrial fibrillation.
Atrial Fibrillation
/ diagnosis
Humans
Cryosurgery
/ economics
Cost-Benefit Analysis
Denmark
Anti-Arrhythmia Agents
/ therapeutic use
Quality-Adjusted Life Years
Treatment Outcome
Drug Costs
Time Factors
Models, Economic
Markov Chains
Quality of Life
Randomized Controlled Trials as Topic
Male
Female
Middle Aged
Decision Support Techniques
Aged
Pulmonary Veins
/ surgery
Cost Savings
Decision Trees
Antiarrhythmic drugs
Atrial fibrillation
Cost-effectiveness
Cryoablation
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
16 Jul 2024
16 Jul 2024
Historique:
received:
04
03
2024
accepted:
02
07
2024
medline:
17
7
2024
pubmed:
17
7
2024
entrez:
16
7
2024
Statut:
epublish
Résumé
Three randomised controlled trials (RCTs) have demonstrated that first-line cryoballoon pulmonary vein isolation decreases atrial tachycardia in patients with symptomatic paroxysmal atrial fibrillation (PAF) compared with antiarrhythmic drugs (AADs). The aim of this study was to develop a cost-effectiveness model (CEM) for first-line cryoablation compared with first-line AADs for the treatment of PAF. The model used a Danish healthcare perspective. Individual patient-level data from the Cryo-FIRST, STOP AF and EARLY-AF RCTs were used to parameterise the CEM. The model structure consisted of a hybrid decision tree (one-year time horizon) and a Markov model (40-year time horizon, with a three-month cycle length). Health-related quality of life was expressed in quality-adjusted life years (QALYs). Costs and benefits were discounted at 3% per year. Model outcomes were produced using probabilistic sensitivity analysis. First-line cryoablation is dominant, meaning it results in lower costs (-€2,663) and more QALYs (0.18) when compared to first-line AADs. First-line cryoablation also has a 99.96% probability of being cost-effective, at a cost-effectiveness threshold of €23,200 per QALY gained. Regardless of initial treatment, patients were expected to receive ∼ 1.2 ablation procedures over a lifetime horizon. First-line cryoablation is both more effective and less costly (i.e. dominant), when compared with AADs for patients with symptomatic PAF in a Danish healthcare system.
Identifiants
pubmed: 39014312
doi: 10.1186/s12872-024-04024-5
pii: 10.1186/s12872-024-04024-5
doi:
Substances chimiques
Anti-Arrhythmia Agents
0
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
363Informations de copyright
© 2024. The Author(s).
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