An Economic Evaluation of a Streamlined Day-Case Atrial Fibrillation Ablation Protocol and Conventional Cryoballoon Ablation versus Antiarrhythmic Drugs in a UK Paroxysmal Atrial Fibrillation Population

Joe W. E. Moss (), Derick Todd, Lukasz Grodzicki, Beatrice Palazzolo, Richard Mattock, Stuart Mealing, Maxim Souter, Benedict Brown, Tom Bromilow, Damian Lewis, James McCready, Muzahir Tayebjee, Ewen Shepherd, Thiagarajah Sasikaran, Clare Coyle, Eleni Ismyrloglou, Nicholas A. Johnson and Prapa Kanagaratnam
Additional contact information
Joe W. E. Moss: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
Derick Todd: Liverpool Heart and Chest Hospital
Lukasz Grodzicki: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
Beatrice Palazzolo: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
Richard Mattock: Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds
Stuart Mealing: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
Maxim Souter: Medtronic Limited
Benedict Brown: Medtronic International Trading Sarl
Tom Bromilow: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
Damian Lewis: York Health Economics Consortium, Enterprise House, Innovation Way, University of York
James McCready: Brighton and Sussex University Hospital
Muzahir Tayebjee: Leeds Teaching Hospitals NHS Trust
Ewen Shepherd: Newcastle-upon-Tyne NHS Foundation Trust
Thiagarajah Sasikaran: Imperial College London
Clare Coyle: National Heart and Lung Institute, Imperial College London
Eleni Ismyrloglou: Medtronic Bakken Research Center B.V.
Nicholas A. Johnson: Imperial College London
Prapa Kanagaratnam: National Heart and Lung Institute, Imperial College London

PharmacoEconomics - Open, 2024, vol. 8, issue 3, No 6, 417-429

Abstract: Abstract Background and Aims Symptom control for atrial fibrillation can be achieved by catheter ablation or drug therapy. We assessed the cost effectiveness of a novel streamlined atrial fibrillation cryoballoon ablation protocol (AVATAR) compared with optimised antiarrhythmic drug (AAD) therapy and a conventional catheter ablation protocol, from a UK National Health Service (NHS) perspective. Methods Data from the AVATAR study were assessed to determine the cost effectiveness of the three protocols in a two-step process. In the first stage, statistical analysis of clinical efficacy outcomes was conducted considering either a three-way comparison (AVATAR vs. conventional ablation vs. optimised AAD therapies) or a two-way comparison (pooled ablation protocol data vs. optimised AAD therapies). In the second stage, models assessed the cost effectiveness of the protocols. Costs and some of the clinical inputs in the models were derived from within-trial cost analysis and published literature. The remaining inputs were derived from clinical experts. Results No significant differences between the ablation protocols were found for any of the clinical outcomes used in the model. Results of a within-trial cost analysis show that AVATAR is cost-saving (£1279 per patient) compared with the conventional ablation protocol. When compared with optimised AAD therapies, AVATAR (pooled conventional and AVATAR ablation protocols efficacy) was found to be more costly while offering improved clinical benefits. Over a lifetime time horizon, the incremental cost-effectiveness ratio of AVATAR was estimated as £21,046 per quality-adjusted life-year gained (95% credible interval £7086–£71,718). Conclusions The AVATAR streamlined protocol is likely to be a cost-effective option versus both conventional ablation and optimised AAD therapy in the UK NHS healthcare setting.

Date: 2024
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s41669-023-00471-6 Abstract (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:pharmo:v:8:y:2024:i:3:d:10.1007_s41669-023-00471-6

Ordering information: This journal article can be ordered from
http://www.springer.com/adis/journal/41669

DOI: 10.1007/s41669-023-00471-6

Access Statistics for this article

PharmacoEconomics - Open is currently edited by Timothy Wrightson and Christopher Carswell

More articles in PharmacoEconomics - Open from Springer
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().