SOCIETAL BURDEN OF ATRIAL FIBRILLATION: A NATIONWIDE COHORT STUDY IN SWEDEN
Author(s)
Amélie Beaudet, MSc, PharmD1, Kelsi Alexandra Smith, PhD2, Jonas Banefelt, MSc2, Michael Hurst, BSc, MSc3, Andrius Kavaliunas, BSc, MPH, PhD4, Timothy Ming, MSc5, Gillian Murphy, MSc2, Ellen O'Brien, PhD6, Nadia Pillai, PhD7, Patrik Sandin, PhD2, Johan Engdahl, Professor8.
1Director, Global Market Access, Johnson & Johnson, Allschwill, Switzerland, 2Quantify Research, Stockholm, Sweden, 3Bristol Myers Squibb, Uxbridge, United Kingdom, 4Johnson & Johnson, Solna, Sweden, 5Janssen-Cilag, High Wycombe, United Kingdom, 6Janssen Global Services, Ambler, PA, USA, 7J&J, Allschwil, Switzerland, 8Karolinska Institutet, Stockholm, Sweden.
1Director, Global Market Access, Johnson & Johnson, Allschwill, Switzerland, 2Quantify Research, Stockholm, Sweden, 3Bristol Myers Squibb, Uxbridge, United Kingdom, 4Johnson & Johnson, Solna, Sweden, 5Janssen-Cilag, High Wycombe, United Kingdom, 6Janssen Global Services, Ambler, PA, USA, 7J&J, Allschwil, Switzerland, 8Karolinska Institutet, Stockholm, Sweden.
OBJECTIVES: Atrial fibrillation (AF) is associated with significant morbidity and mortality, yet productivity loss remains underexplored. This nationwide Swedish cohort study aimed to quantify this burden in working-age patients with AF relative to matched general population controls.
METHODS: Adults newly diagnosed with AF between 2013 and 2023 were identified from linked registers of inpatient and specialist outpatient hospital care. The index date was the outpatient visit or hospital discharge date for AF diagnosis. Exclusion criteria were prior AF and chronic bleeding disorders (12 years pre-index), migration (5 years), active cancer (1 year), or in-hospital death. Working-age patients (18-65 years) were matched with controls (1:5) by age, sex, and region. Productivity loss (i.e., sickness absence >14 days or disability pension), reported as mean full-day equivalents (FDE) for all-cause and cardiovascular (CV)-related causes, was calculated annually for 5 years pre- and post-index. Analyses were stratified by sex.
RESULTS: The analysis included 66,803 working-age patients matched to 324,441 controls. At 5 years pre-index, mean all-cause productivity loss was higher in the AF cohort than controls (49.9 vs 38.2 FDE). Productivity loss in patients with AF peaked within 1 year post-index (75.6 vs 38.7 FDE), driven by an increase in all-cause sickness absence (40.3 vs 11.4 FDE). CV-related productivity loss rose from 5.0 FDE at 5 years pre-index to 22.6 FDE 1 year post-index (vs 2.2 FDE in controls). Across the study period, productivity loss remained higher in patients with AF than controls, including at 5 years post-index for all-cause (54.1 vs 35.8) and CV-related (10.6 vs 1.9). All-cause productivity loss was approximately twofold higher in women, while CV-related productivity loss was comparable.
CONCLUSIONS: Working-age patients with AF incur substantial productivity loss, elevated before diagnosis and peaking 1 year after. These findings underscore the multifactorial nature of AF, including its complex comorbidity burden and associated complications.
METHODS: Adults newly diagnosed with AF between 2013 and 2023 were identified from linked registers of inpatient and specialist outpatient hospital care. The index date was the outpatient visit or hospital discharge date for AF diagnosis. Exclusion criteria were prior AF and chronic bleeding disorders (12 years pre-index), migration (5 years), active cancer (1 year), or in-hospital death. Working-age patients (18-65 years) were matched with controls (1:5) by age, sex, and region. Productivity loss (i.e., sickness absence >14 days or disability pension), reported as mean full-day equivalents (FDE) for all-cause and cardiovascular (CV)-related causes, was calculated annually for 5 years pre- and post-index. Analyses were stratified by sex.
RESULTS: The analysis included 66,803 working-age patients matched to 324,441 controls. At 5 years pre-index, mean all-cause productivity loss was higher in the AF cohort than controls (49.9 vs 38.2 FDE). Productivity loss in patients with AF peaked within 1 year post-index (75.6 vs 38.7 FDE), driven by an increase in all-cause sickness absence (40.3 vs 11.4 FDE). CV-related productivity loss rose from 5.0 FDE at 5 years pre-index to 22.6 FDE 1 year post-index (vs 2.2 FDE in controls). Across the study period, productivity loss remained higher in patients with AF than controls, including at 5 years post-index for all-cause (54.1 vs 35.8) and CV-related (10.6 vs 1.9). All-cause productivity loss was approximately twofold higher in women, while CV-related productivity loss was comparable.
CONCLUSIONS: Working-age patients with AF incur substantial productivity loss, elevated before diagnosis and peaking 1 year after. These findings underscore the multifactorial nature of AF, including its complex comorbidity burden and associated complications.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE460
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)