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Incremental cost burden to US healthcare payers of atrial fibrillation/atrial flutter patients with additional risk factors

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Abstract

Introduction

Atrial fibrillation (AF) and atrial flutter (AFL) patients often have cardiovascular (CV) comorbidities, and have an increased risk of hospitalization and death. Little is known about the real-world cost burden of AF/AFL patients with additional risk factors (ARF). We evaluated the medical resource use and cost burden of AF/AFL patients with ≥1 ARF (other than heart failure [HF]), in comparison with non-AF/AFL controls.

Methods

This retrospective cohort study included patients from the MarketScan Medicare database who had ≥1 inpatient or ≥2 outpatient AF/AFL claims. Patients were (1) ≥75 years of age or (2) 70–74 years of age with ≥1 ARF (hypertension, diabetes, systemic embolism, or stroke/transient ischemic attack), but without HF. The AF/AFL patients were matched on age, gender, region, and enrollment status with non-AF/AFL patients. Hospital resource use and costs over the 12-month post-index period were compared across cohorts. The impacts of comorbidity were seen by subcategorizing hospitalization as all-cause, CV-related, and AF/AFL-related.

Results

AF/AFL patients with ≥1 ARF had a higher prevalence of comorbidity than non-AF/AFL patients (n=58,555/cohort). Hospitalizations (all-causality) were more than three times more frequent and of longer duration in AF/AFL patients with ≥1 ARF than in non-AF/AFL controls (mean [SD]: 0.72 [0.87] vs. 0.21 [0.51] hospitalizations per patient per year and 3.85 [9.30] and 1.03 [4.53] days, respectively; both P<0.0001). Overall mean (SD) costs over the 12-month post-index period were higher in AF/AFL patients with ≥1 ARF versus the non-AF/AFL control patients for inpatient ($9613 [25,407] vs. $2625 [11,597]; P<0.0001; incremental cost $6988), outpatient ($9447 [15,062] vs. $4906 [11,715]; P<0.0001; incremental cost $4541), and prescription drug costs ($3430 [3637] vs. $2618 [3374]; P<0.0001; incremental cost $812).

Conclusion

AF/AFL patients with ≥1 ARF had significantly greater levels of comorbidity, hospitalizations, prescription, and outpatient claims than non-AF/AFL patients. The incremental costs of AF/AFL patients with ≥1 ARF are largely due to higher CV-related inpatient costs.

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Authors and Affiliations

  1. University of California Irvine Medical Center, 101 the City Drive South, Building 26, Room 1005, ZC-4076H, Mail Code 4076H, Irvine, CA, 92868, USA

    Alpesh N. Amin

  2. sanofi-aventis US, Bridgewater, New Jersey, USA

    Mehul Jhaveri

  3. Novosys Health, Flemington, New Jersey, USA

    Jay Lin

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  1. Alpesh N. Amin
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  2. Mehul Jhaveri
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Correspondence to Alpesh N. Amin.

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Amin, A.N., Jhaveri, M. & Lin, J. Incremental cost burden to US healthcare payers of atrial fibrillation/atrial flutter patients with additional risk factors. Adv Therapy 28, 907–926 (2011). https://doi.org/10.1007/s12325-011-0065-6

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