Real-World Health Care Resource Utilization and Costs Associated With First-Line Dronedarone Versus First-Line...

Area of Science:

• Cardiology
• Health Economics
• Pharmacotherapy

Background:

• Atrial fibrillation (AF) rhythm control often involves antiarrhythmic drugs (AADs) or catheter ablation.
• The comparative impact of first-line AADs, including dronedarone, versus ablation on healthcare resource utilization (HCRU) remains unclear.

Purpose of the Study:

• To compare health care resource utilization and costs between first-line dronedarone and catheter ablation for atrial fibrillation treatment.

Main Methods:

• A retrospective cohort study using de-identified US claims data (2012-2022).
• Propensity score matching compared patients receiving first-line dronedarone versus first-line ablation (including AADs then ablation).
• Health care resource utilization and per-patient per-month (PPPM) costs were analyzed over 24 months.

Main Results:

• Post-matching, 1440 patients were analyzed. First-line dronedarone was associated with significantly lower event rate ratios for inpatient, outpatient, and emergency room visits, and AF-related procedures compared to ablation.
• Dronedarone also demonstrated significantly lower mean PPPM costs for total HCRU, outpatient visits, and AF-related procedures.

Conclusions:

• First-line dronedarone therapy for AF is associated with comparable inpatient/outpatient visit rates and lower total payer costs over 24 months compared to an ablation-based approach.
• These findings suggest dronedarone as a cost-effective initial rhythm control strategy in AF management.