Supplementary tables: Clinical and economic outcomes associated with use of anti-arrhythmic drugs versus ablation in atrial fibrillation

These are peer-reviewed supplementary data for the article 'Clinical and economic outcomes associated with use of anti-arrhythmic drugs versus ablation in atrial fibrillation' published in the Journal of Comparative Effectiveness Research.Supplementary table 1: Risk of occurrence of LTCO in direct comparison of individual drugs scenarioSupplementary table 2: LTCO risk of treatments (non-temporal scenarios)Supplementary table 3: LTCO risk of treatments (temporal scenarios)Aim: To evaluate the clinical and economic impact of antiarrhythmic drugs (AADs) compared with ablation both as individual treatments and as combination therapy without/with considering the order of treatment among patients with atrial fibrillation (AFib). Materials & methods: A budget impact model over a one-year time horizon was developed to assess the economic impact of AADs (amiodarone, dofetilide, dronedarone, flecainide, propafenone, sotalol, and as a group) versus ablation across three scenarios: direct comparisons of individual treatments, non-temporal combinations, and temporal combinations. The economic analysis was conducted in accordance with CHEERS guidance as per current model objectives. Results are reported as costs per patient per year (PPPY). The impact of individual parameters was evaluated using one-way sensitivity analysis (OWSA). Results: In direct comparisons, ablation had the highest annualmedication/procedure cost ($29,432), followed by dofetilide ($7661), dronedarone ($6451), sotalol ($4552), propafenone ($3044), flecainide ($2563), and amiodarone ($2538). lecainide had the highest costs for long-term clinical outcomes ($22,964), followed by dofetilide ($17,462), sotalol ($15,030), amiodarone ($12,450), dronedarone ($10,424), propafenone ($7678) and ablation ($9948). In the non-temporal scenario, total costs incurred for AADs (group) + ablation ($17,278) were lower compared with ablation alone ($39,380). In the temporal scenario, AADs (group) before ablation resulted in PPPY cost savings of ($22,858) compared with AADs (group) after ablation ($19,958). Key factors in OWSA were ablation costs, the proportion of patients having reablation, and withdrawal due to adverse events. Conclusion: Utilization of AADs as individual treatment or in combination with

本数据集为发表于《比较有效性研究杂志》之文章《使用抗心律失常药物与消融治疗心房颤动相关临床及经济结果》的同行评审补充数据。补充表1：个体药物场景中长程临床结局（LTCO）发生的风险；补充表2：治疗（非时间性场景）的LTCO风险；补充表3：治疗（时间性场景）的LTCO风险。研究目标：评估抗心律失常药物（AADs）与消融治疗在作为单一治疗方案及联合治疗时，对于心房颤动（AFib）患者临床及经济的综合影响，并考虑治疗顺序。研究材料与方法：构建了一个为期一年的预算影响模型，以评估AADs（包括胺碘酮、多非利特、多罗非酮、氟卡尼、普罗帕酮、索他洛尔，以及作为一个群体）与消融治疗在三种情景下的经济影响：个体治疗的直接比较、非时间性联合，以及时间性联合。经济分析遵循CHEERS指南进行，符合当前模型目标。结果以每患者每年成本（PPPY）的形式报告。使用单因素敏感性分析（OWSA）评估了各个参数的影响。研究结果：在直接比较中，消融治疗的年度药物/手术成本最高，为29,432美元，其次是多非利特（7,661美元）、多罗非酮（6,451美元）、索他洛尔（4,552美元）、普罗帕酮（3,044美元）、氟卡尼（2,563美元）和胺碘酮（2,538美元）。在长期临床结局方面，利卡因的成本最高，为22,964美元，其次是多非利特（17,462美元）、索他洛尔（15,030美元）、胺碘酮（12,450美元）、多罗非酮（10,424美元）、普罗帕酮（7,678美元）和消融治疗（9,948美元）。在非时间性情景下，AADs（作为一个群体）+消融治疗的总成本（17,278美元）低于单独消融治疗（39,380美元）。在时间性情景下，与消融治疗后使用AADs（作为一个群体）相比，消融治疗前的AADs（作为一个群体）导致每患者每年成本节省（22,858美元）。OWSA的关键因素包括消融治疗成本、需要再次消融治疗的患者比例以及因不良事件而停药的比例。结论：将AADs作为单一治疗或联合治疗使用，可有效地降低心房颤动患者的治疗成本。