Cost-Effectiveness of Rate-Control vs Rhythm-Control in Atrial Fibrillation
Author Information
Author(s): Elisabeth Fenwick, Deborah A Marshall, Adrian R Levy, Graham Nichol
Primary Institution: Public Health and Health Policy, University of Glasgow, Glasgow, UK
Hypothesis
Is rate-control in the management of patients with atrial fibrillation 'good value for money' compared to rhythm-control?
Conclusion
Rate-control is a cost-effective approach to managing atrial fibrillation compared to rhythm-control, despite no statistically significant difference in survival.
Supporting Evidence
- Rate-control was less costly than rhythm-control by US $5,077 per person.
- The CEAC shows that the decision uncertainty surrounding the adoption of rate-control strategies is less than 1.7%.
- 95% of bootstrap replicates showed that rate-control was less costly and more effective than rhythm-control.
Takeaway
This study shows that using rate-control for patients with atrial fibrillation is cheaper and just as good as rhythm-control, making it a better choice.
Methodology
A retrospective cost-effectiveness analysis of the AFFIRM randomized controlled trial.
Limitations
The study's findings are based on a non-significant mean survival gain and may not apply to all patient populations.
Participant Demographics
Patients with atrial fibrillation, aged 65 or older or with other risk factors for stroke or death.
Statistical Information
P-Value
0.10
Confidence Interval
95% CI: -0.1 years to 0.24 years; 95% CI: -$1,100 to -$11,006
Statistical Significance
p=0.10
Digital Object Identifier (DOI)
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