PRECISION COST-EFFECTIVENESS ANALYSIS OF RADIOFREQUENCY CATHETER ABLATION IN A REAL-WORLD ATRIAL FIBRILLATION POPULATION
Author(s)
Sun N1, Chen Y2, Xie X2, Gao L2, Xie G1, Dong P2
1IBM Research, Beijing, China, 2Pfizer Investment Co., Ltd., Beijing, China
OBJECTIVES: Cost-effectiveness of treating atrial fibrillation (A-fib) with radiofrequency catheter ablation (RFA) has been analyzed in several studies based on decision-analytic Markov models. The aim of this study was to re-evaluate this topic using a novel framework based on real world evidence (RWE), and identify precision cohorts in which RFA was more cost-effective. METHODS: A 3-year registry data of 8302 Chinese A-fib patients were used for the economic evaluation of RFA using clinical metrics (e.g., mortality rate, occurrence of adverse events) and economic metrics (incremental cost-effectiveness ratio (ICER), and net monetary benefit (NMB)). Patient population was further segmented into sub-cohorts based on patients’ features including demographic information, chronic conditions, current drug treatments, and clinical test results to differentiate the effect of the RFA treatment. RESULTS: Positive clinical effectiveness of RFA were observed in the overall population, with a lower mortality rate of 0.985% in treated patients compared with 4.744% in non-treated patients, a gain of 0.098 quality-adjusted life years (QALYs) associated with an incremental cost of ¥¥¥¥) benefited significantly more from RFA. The advantages and limitations of using ICER and NMB to evaluate short-term cost-effectiveness through RWE were also discussed. CONCLUSIONS: RFA was shown to be a cost-effective treatment in a real-world A-fib population, in which sub-cohorts of patients gaining more NMB from RFA were identified. This approach may have implications for further explorations in precision health economics and outcomes research.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCV75
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders