CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

May 4th, 2011

Study Estimates That Atrial Fibrillation Adds $26 Billion to Yearly U.S. Healthcare Costs

Atrial fibrillation may add $26 billion to the nation’s healthcare bill, according to a study published in Circulation: Cardiovascular Quality and Outcomes. Michael Kim and colleagues compared insurance claims for 1 year from 89,066 AF patients with claims from controls matched for gender, age, and other medical conditions and found that AF results in a net incremental cost  per patient per year of $8,705.

Most of the additional costs came from more frequent hospitalizations in the AF group: AF patients were twice as likely as controls to be hospitalized (37.5% vs. 17.5%) and three times as likely to have multiple hospitalizations (11.1% vs. 3.3%). Some $6 billion was spent directly on costs related to AF; $9.9 billion for non-AF cardiovascular care; and $10.1 billion went for noncardiovascular health costs.

“We’re not going to impact healthcare costs or cardiovascular outcomes by just addressing atrial fibrillation itself,” said Michael Kim, the lead author of the study, in an AHA press release. “The large amount of cardiovascular disease among atrial fibrillation patients appears to worsen outcomes and increase costs. This is a sicker population.”

Sanofi-Aventis, the manufacturer of the AF drug dronedarone (Multaq), provided financial and editorial support for the development of the manuscript of the paper.

Categories: Electrophysiology
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4 Responses to “Study Estimates That Atrial Fibrillation Adds $26 Billion to Yearly U.S. Healthcare Costs”

  1. Saurav Chatterjee, MD says:
    May 4, 2011 at 8:14 pm

    impressive numbers…might be interesting to see if rate vs rhythm control for AF have similar cost-effectiveness-any one know of any studies which examined this?

    Competing interests pertaining specifically to this post, comment, or both:
    none

  2. Saurav Chatterjee, MD says:
    May 4, 2011 at 10:49 pm

    Just found one analysis of cost effectiveness data-
    http://www.ncbi.nlm.nih.gov/pubmed/15520421

    Competing interests pertaining specifically to this post, comment, or both:
    None

  3. Mario Maiese, DO says:
    May 5, 2011 at 7:35 am

    Thanks Dr Chatterjee. Comparative effectiveness says rate control compared to rhythm control is equal with regard to outcomes. The next issue then becomes cost. There is no doubt that rate control and decreasing embolic risk with generic drugs is cheaper than rhythm control with brand-name drugs, ablation, cardioversion and admissions associated with failure (they all still need embolic risk reduction based on CHADS2 score). Greater then 90% of patients with AF can be managed with rate control and supportive reassurance in a more cost-effective manner.

    Competing interests pertaining specifically to this post, comment, or both:
    none

  4. Giuseppe Marino Benvenuto, MD says:
    May 9, 2011 at 6:44 am

    I strongly agree with Dr. Maiese: in the most majority of AF patients (expecially those > 65 years old and/or less active pts) is less difficult and expensive to treat them by rate-control strategy than by rhytm-control one.

    Competing interests pertaining specifically to this post, comment, or both:
    none