Axtria Inc., Decision Science, Health Economics and Outcomes Research / Real-World Evidence, Berkley Heights, NJ 07922, USA.
Sanofi US, US General Medicines, Bridgewater, NJ 08807, USA.
J Comp Eff Res. 2023 Apr;12(4):e220196. doi: 10.57264/cer-2022-0196. Epub 2023 Mar 14.
The budgetary consequences of increasing dronedarone utilization for treatment of atrial fibrillation were evaluated from a US payer perspective. A budget impact model over a 5-year time horizon was developed, including drug-related costs and risks for long-term clinical outcomes (LTCOs). Treatments included antiarrhythmic drugs (AADs; dronedarone, amiodarone, sotalol, propafenone, dofetilide, flecainide), rate control medications, and ablation. Direct comparisons and temporal and non-temporal combination scenarios investigating treatment order were analyzed as costs per patient per month (PPPM). By projected year 5, costs PPPM for dronedarone versus other AADs decreased by $37.69 due to fewer LTCOs, treatment with dronedarone versus ablation or rate control medications + ablation resulted in cost savings ($359.94 and $370.54, respectively), and AADs placed before ablation decreased PPPM costs by $242 compared with ablation before AADs. Increased dronedarone utilization demonstrated incremental cost reductions over time.
从美国支付者的角度评估了增加决奈达隆的使用量来治疗心房颤动的预算后果。在 5 年的时间范围内建立了一个预算影响模型，包括与药物相关的成本和长期临床结果（LTCO）的风险。治疗方法包括抗心律失常药物（AAD；决奈达隆、胺碘酮、索他洛尔、普罗帕酮、多非利特、氟卡尼）、心率控制药物和消融。作为每个患者每月的成本（PPPM），对治疗顺序的直接比较和时间和非时间组合方案进行了分析。到预计的第 5 年，与其他 AAD 相比，决奈达隆的 PPPM 成本降低了 37.69 美元，原因是 LTCO 减少，与消融或心率控制药物+消融相比，使用决奈达隆治疗可节省成本（分别为 359.94 美元和 370.54 美元），与消融前使用 AAD 相比，消融前使用 AAD 可降低 PPPM 成本 242 美元。随着时间的推移，决奈达隆的使用增加显示出增量成本的降低。
