Cost-effectiveness of cryoballoon ablation for the management of paroxysmal atrial fibrillation. Issue 5 (2nd January 2014)

• Record Type: Journal Article
• Authors: Reynolds, Matthew R.; Lamotte, Mark; Todd, Derick; Khaykin, Yaariv; Eggington, Simon; Tsintzos, Stelios; Klein, Gunnar
• Is Part Of: Europace. Volume 16:Issue 5(2014:May)
• Page Start: 652
• Page End: 659
• Publication Date: 2014-01-02
• Subjects: Cost-effectiveness analysis -- Atrial fibrillation -- Quality of life -- Stroke -- Cryoablation; Arrhythmia -- Treatment -- Periodicals; Cardiac pacing -- Periodicals; Catheter ablation -- Periodicals; Heart -- Physiology -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1093/europace/eut380
• Languages: English
• ISSNs: 1099-5129

Abstract

Abstract : Aims: Cryoballoon ablation is an established treatment option for the management of patients with atrial fibrillation. We sought to evaluate the cost-effectiveness of cryoablation, compared with second-line anti-arrhythmic drug (AAD) therapy in patients with paroxysmal atrial fibrillation (PAF), from a UK payer perspective. Methods and results: We developed a state-transition (Markov) model to calculate the total costs and quality-adjusted life-years (QALYs) associated with cryoablation and AAD therapy in patients with PAF. A 5-year horizon was used for the base-case. Data from a recent study of cryoballoon ablation in patients with PAF were used to model short-term health outcomes and costs, together with longer term external evidence to populate subsequent time periods. Total discounted costs were £21 162 and £17 627 for the cryoballoon ablation and AAD arms, respectively. Total QALYs of 3.565 and 3.404 therefore led to an incremental cost-effectiveness ratio of £21 957 per QALY gained. Sensitivity analysis suggested that the key drivers of the results were the model time horizon, the costs of follow-up care in patients with recurrent AF, and the costs of the ablation procedure. Conclusion: Cryoballoon ablation provides increased quality-adjusted life expectancy compared with AAD at reasonable additional cost, representing good value for money in patients with PAF.