Abstract 16555: The Effects of Catheter Ablation Treatment on Medication Use and Expenditures in Patients with Atrial Fibrillation
Aim: To estimate the short and long term impact of catheter ablation on rhythm medication utilization and drug expenditures among atrial fibrillation (AF) patients in general and Medicare populations.
Methods: A retrospective analysis of patient data from the MarketScan® Research Database from Thomson Reuters was performed. This database contains individual level, de-identified, claims information from employers, health plans, hospitals, Medicare, and Medicaid. Patients with AF with a documented catheter ablation procedure, who had continuous enrollment in the database six months prior to their first ablation, and a minimum of one year follow-up post first ablation were matched to patients with AF and similar observable characteristics who did not receive the procedure. Multivariable regression models for drug utilization and expenditures were built for all patients, and sub-analyses were performed for patients 65 and over.
Results were reported for five samples, based on duration of available follow-up time of at least 12 months, 18 months, 2 years, 2.5 years, and 3 years post ablation. In addition, the analysis was replicated using a larger unmatched sample of AF patients, clustered by their healthcare utilization patterns. Results: Significant reductions in drug use and expenditures were noted after catheter ablation, compared with patients who had not received the procedure. These results were consistent for the subset of patients 65 and older. The effects were strongest for the matched sample, where an absolute reduction in the frequency of rhythm medication use of 30-35% was seen. Patients experienced a significant reduction in medication expenditures ranging from $800 to $1,200 per year in the matched sample.
Conclusion: Catheter ablation for AF reduced medication utilization and expenditures in a sustainable fashion up to 3 years post ablation. This reduction was consistent and significant in both the non-Medicare and Medicare populations.
- © 2012 by American Heart Association, Inc.