A value-based budget impact model for dronedarone compared with other rhythm control strategies

Area of Science:

• Pharmacoeconomics
• Cardiology
• Health Economics

Background:

• Atrial fibrillation (AF) management involves various antiarrhythmic drugs (AADs), rate control medications, and ablation.
• Dronedarone is an AAD used in AF treatment, with its cost-effectiveness being a key consideration for payers.
• Understanding the budgetary impact of shifting treatment paradigms is crucial for healthcare systems.

Purpose of the Study:

• To evaluate the budgetary consequences of increased dronedarone utilization for atrial fibrillation from a US payer perspective.
• To compare the cost-effectiveness of dronedarone against other AADs, ablation, and combination therapies.
• To analyze the impact of treatment sequencing on overall healthcare costs.

Main Methods:

• A 5-year budget impact model was developed.
• Included drug-related costs and risks for long-term clinical outcomes (LTCOs).
• Analyzed direct comparisons and temporal/non-temporal combination scenarios of treatments (AADs, rate control, ablation) as costs per patient per month (PPPM).

Main Results:

• By year 5, dronedarone use decreased costs PPPM by $37.69 compared to other AADs due to fewer LTCOs.
• Dronedarone treatment resulted in cost savings of $359.94 and $370.54 versus ablation and rate control + ablation, respectively.
• Sequencing AADs before ablation decreased PPPM costs by $242 compared to ablation before AADs.

Conclusions:

• Increased utilization of dronedarone demonstrates incremental cost reductions over time for US payers.
• Dronedarone offers a cost-effective treatment option in atrial fibrillation management, particularly when compared to ablation.
• Optimizing treatment sequences, prioritizing AADs before ablation, can further enhance cost savings.