Rapid Access Atrial Fibrillation Clinics in Australia - Modelling Outcomes and Cost-Effectiveness

Area of Science:

• Cardiology
• Health Economics
• Public Health

Background:

• Atrial fibrillation (AF) management requires risk assessment and anticoagulation for stroke prevention.
• Rapid Access Atrial Fibrillation (RAAF) clinics offer multidisciplinary care to minimize stroke risk duration.
• The clinical outcomes and cost-effectiveness of RAAF clinics remain under investigation.

Purpose of the Study:

• To conduct a cost-effectiveness evaluation of an RAAF clinic from a healthcare system perspective.
• To compare the RAAF clinic model against standard care in Australia.

Main Methods:

• A microsimulation model was developed using data from 274 individuals referred to an RAAF clinic.
• Stroke, bleeding, and death risks were estimated using the GARFIELD equation.
• A comparator cohort received standard care via a general cardiology clinic over a 2-year horizon, with 1000 replications.

Main Results:

• RAAF clinic participants experienced fewer strokes, bleeding events, and deaths compared to standard care.
• Marginal increases in quality-adjusted life years (QALYs) were observed.
• The RAAF clinic model resulted in cost savings of AUD$74 per person, with a dominant incremental cost-effectiveness ratio (ICER).

Conclusions:

• RAAF clinics are effective in preventing strokes and bleeding events in AF patients.
• These clinics are cost-saving and offer potential returns on investment.
• Adoption of the RAAF clinic model by policymakers can improve the delivery of safe, effective, and economical care for AF patients.