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The Cost of Atrial Fibrillation: A Systematic Review.

Authors
  • Buja, Alessandra1
  • Rebba, Vincenzo2
  • Montecchio, Laura1
  • Renzo, Giulia3
  • Baldo, Vincenzo1
  • Cocchio, Silvia1
  • Ferri, Nicola4
  • Migliore, Federico1
  • Zorzi, Alessandro1
  • Collins, Brendan5
  • Amrouch, Cheïma6
  • De Smedt, Delphine7
  • Kypridemos, Christodoulos5
  • Petrovic, Mirko8
  • O'Flaherty, Martin9
  • Lip, Gregory10
  • 1 Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy. , (Italy)
  • 2 Department of Economics and Management 'Marco Fanno', University of Padua, and Interuniversity Research Centre of Public Economics (CRIEP), Padua, Italy. Electronic address: [email protected]. , (Italy)
  • 3 Department of Economics and Management 'Marco Fanno', University of Padua, Italy. , (Italy)
  • 4 Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Italy. , (Italy)
  • 5 Department of Public Health, Policy & Systems - Institute of Population Health, University of Liverpool, United Kingdom. , (United Kingdom)
  • 6 Department of Internal Medicine and Paediatrics, Ghent University, Belgium; Department of Public Health and Primary Care, Ghent University, Belgium. , (Belgium)
  • 7 Department of Public Health and Primary Care, Ghent University, Belgium. , (Belgium)
  • 8 Department of Internal Medicine and Paediatrics, Ghent University, Belgium. , (Belgium)
  • 9 Department of Public Health, Policy & Systems - Institute of Population Health, University of Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom. , (United Kingdom)
  • 10 Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom. , (United Kingdom)
Type
Published Article
Journal
Value in Health
Publisher
Elsevier
Publication Date
Jan 29, 2024
Identifiers
DOI: 10.1016/j.jval.2023.12.015
PMID: 38296049
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia, with an increasing incidence and prevalence due to progressively ageing populations. Costs related to AF are both direct and indirect. This systematic review aims to identify the main cost drivers of the illness, assess the potential economic impact resulting from changes in care strategies and propose interventions where they are most needed. A systematic literature search of the PubMed and Scopus databases was performed to identify analytical observational studies defining the cost of illness in cases of AF. The search strategy was based on the PRISMA 2020 recommendations. Of the 944 articles retrieved, 24 met the inclusion criteria. These studies were conducted in several countries. All studies calculated the direct medical costs, while 8 out of 24 studies assessed indirect costs. The median annual direct medical cost per patient, considering all studies, was €9,409 (13,333 US dollars in purchasing power parities), with a very large variability due to the heterogeneity of different analyses. Hospitalisation costs are generally the main cost drivers. Comorbidities and complications, such as stroke, considerably increase the average annual direct medical cost of AF. In most of the analysed studies, inpatient care cost represents the main component of the mean direct medical cost per patient. Stroke and heart failure are responsible for a large share of the total costs; therefore, implementing guidelines to manage comorbidities in AF is a necessary step to improve health and mitigate healthcare costs. Copyright © 2024 International Society for Pharmacoeconomics and Outcomes Research, Inc. Published by Elsevier Inc. All rights reserved.

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