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Economic impact of the reduced incidence of atrial fibrillation in patients with heart failure treated with enalapril.
Am Heart J. 2005 Nov; 150(5):985.AH

Abstract

BACKGROUND

Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% over 2.9 years, P < .0001). The objective of this study was to predict economic benefits over 5 and 10 years of reduced AF incidence in patients receiving enalapril for the treatment of HF from a Canadian third-party payer perspective.

METHODS

Consequences of reduced incidence of AF in enalapril-treated patients were modeled using a Markov model. Patients were assigned to 1 health state: no AF, AF, poststroke, or death, and moved from one state to the other according to published incidence rates. It was assumed that most patients with AF would receive warfarin for stroke prevention. Resource use and costs were mostly retrieved from published Canadian studies.

RESULTS

Reduced incidence of AF resulted in savings of 382 dollars and 525 dollars per patient treated with enalapril over 5 and 10 years, respectively, which stemmed mainly from reduced AF hospitalization and less need for warfarin and amiodarone. Sensitivity analyses demonstrated that enalapril becomes more cost saving as the baseline risk for embolic stroke in patients with AF increases and the use of warfarin prophylaxis decreases.

CONCLUSIONS

Reduced incidence of AF with enalapril leads to significant clinical and economic advantages on top of the already well-established benefits of enalapril for patients with HF.

Authors+Show Affiliations

BioMedCom Consultants, Inc, Montreal, Quebec, Canada. monika_wagner@biomedcom.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16290980

Citation

Wagner, Monika, et al. "Economic Impact of the Reduced Incidence of Atrial Fibrillation in Patients With Heart Failure Treated With Enalapril." American Heart Journal, vol. 150, no. 5, 2005, p. 985.
Wagner M, Rindress D, Desjardins B, et al. Economic impact of the reduced incidence of atrial fibrillation in patients with heart failure treated with enalapril. Am Heart J. 2005;150(5):985.
Wagner, M., Rindress, D., Desjardins, B., Meilleur, M. C., Ducharme, A., & Tardif, J. C. (2005). Economic impact of the reduced incidence of atrial fibrillation in patients with heart failure treated with enalapril. American Heart Journal, 150(5), 985.
Wagner M, et al. Economic Impact of the Reduced Incidence of Atrial Fibrillation in Patients With Heart Failure Treated With Enalapril. Am Heart J. 2005;150(5):985. PubMed PMID: 16290980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic impact of the reduced incidence of atrial fibrillation in patients with heart failure treated with enalapril. AU - Wagner,Monika, AU - Rindress,Donna, AU - Desjardins,Brigitte, AU - Meilleur,Marie-Claude, AU - Ducharme,Anique, AU - Tardif,Jean-Claude, PY - 2004/10/28/received PY - 2005/07/12/accepted PY - 2005/11/18/pubmed PY - 2005/12/31/medline PY - 2005/11/18/entrez SP - 985 EP - 985 JF - American heart journal JO - Am Heart J VL - 150 IS - 5 N2 - BACKGROUND: Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% over 2.9 years, P < .0001). The objective of this study was to predict economic benefits over 5 and 10 years of reduced AF incidence in patients receiving enalapril for the treatment of HF from a Canadian third-party payer perspective. METHODS: Consequences of reduced incidence of AF in enalapril-treated patients were modeled using a Markov model. Patients were assigned to 1 health state: no AF, AF, poststroke, or death, and moved from one state to the other according to published incidence rates. It was assumed that most patients with AF would receive warfarin for stroke prevention. Resource use and costs were mostly retrieved from published Canadian studies. RESULTS: Reduced incidence of AF resulted in savings of 382 dollars and 525 dollars per patient treated with enalapril over 5 and 10 years, respectively, which stemmed mainly from reduced AF hospitalization and less need for warfarin and amiodarone. Sensitivity analyses demonstrated that enalapril becomes more cost saving as the baseline risk for embolic stroke in patients with AF increases and the use of warfarin prophylaxis decreases. CONCLUSIONS: Reduced incidence of AF with enalapril leads to significant clinical and economic advantages on top of the already well-established benefits of enalapril for patients with HF. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16290980/Economic_impact_of_the_reduced_incidence_of_atrial_fibrillation_in_patients_with_heart_failure_treated_with_enalapril_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(05)00755-6 DB - PRIME DP - Unbound Medicine ER -