Cost-effectiveness analysis of dronedarone versus other anti-arrhythmic drugs for the treatment of atrial fibrillation—results for Canada, Italy, Sweden and Switzerland

• Published in: The European journal of health economics Vol. 14; no. 3; pp. 481 - 493
• Main Authors: Nilsson, Jonas, Åkerborg, Örjan, Bégo-Le Bagousse, Gaëlle, Rosenquist, Mårten, Lindgren, Peter
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer 01.06.2013; Springer-Verlag
• Subjects: Age Factors; Amiodarone - analogs & derivatives; Amiodarone - economics; Amiodarone - therapeutic use; Anti-Arrhythmia Agents - economics; Anti-Arrhythmia Agents - therapeutic use; Assumption of risk; Atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Canada; Cardiovascular Diseases - economics; Cardiovascular Diseases - etiology; Clinical trials; Comparators; Congestive heart failure; Cost-Benefit Analysis; Economic Policy; Europe; Health Care Management; Health Economics; Health Status; Humans; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Modeling; Models, Economic; Monitoring costs; Mortality; Original Paper; Pharmacoeconomics and Health Outcomes; Public Finance; Public Health; Quality-Adjusted Life Years; Randomized Controlled Trials as Topic; Sex Factors; Strokes; Survival Analysis; Utilities costs; Canada; Europe; C53; Microsimulation; H51; Atrial fibrillation; ATHENA clinical trial; C15; I10; E27; Cost-effectiveness; Dronedarone
• ISSN: 1618-7598; 1618-7601; 1618-7601
• DOI: 10.1007/s10198-012-0391-x

The ATHENA clinical trial enrolled 4,628 patients in 37 countries and evaluated the efficacy of dronedarone 400 mg twice daily versus placebo for the prevention of cardiovascular hospitalisation or death from any cause in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. The trial showed a statistically significant 24 % reduction in the primary endpoint cardiovascular hospitalisations or all-cause death. In the current paper, parameters that drive the cost-effectiveness of dronedarone on top of standard therapy versus likely comparators, i.e. amiodarone, sotalol and flecainide, were investigated by means of a health economic model based on the ATHENA clinical trial. Dronedarone is cost-effective, and ICERs are low versus amiodarone with €5,340; €4,620; €3,850 and €5,630 per QALY gained for Canada, Italy, Sweden and Switzerland, respectively. The most significant driving factor for the cost-effectiveness of dronedarone is the increased survival rate for patients on dronedarone.