Pharmacoeconomic Evaluation of Radiofrequency Ablation versus Amiodarone for Atrial Fibrillation_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHONGDai-yun ¹ , LIUAi-jun ¹ , LUOChu-jun ¹ , LIUXiao-qi ² ,  ZHANGJian-ping ¹

1. College of Pharmacy, Jinan University, Guangzhou 510632, China;
2. Department of Pharmacy, Guangdong Provincial People's Hospital, Guangzhou 510080, China;

Corresponding?author：

ZHANGJian-ping, Email: tzhangjp@jnu.edu.cn

Keywords：

Radiofrequency ablation; Amiodarone; Artrial fibrillation; Pharmacoeconomics; Systematic review

DOI：

10.7507/1672-2531.20150170

Video：

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Objective To systematically evaluate the pharmacoeconomic value of radiofrequency ablation (RFA) versus amiodarone in the treatment of atrial fibrillation (AF), and to provide reference for treatment scheme selection, drug selection and the formulation of drug policy. Methods We searched databases including PubMed, The Cochrane Library, CNKI and CBM from 2000 to 2014 to collect pharmacoeconomic studies on RFA versus Amiodarone for treating AF. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. The cost-effectiveness of RFA and Amiodarone for AF was compared according to the cost, effectiveness, and incremental cost-effectiveness ratio (ICER). Results A total of three studies were included. The results of pharmacoeconomic evaluation showed that the ICERs for each study were $7 976 to $29 068, ￡7 763 to ￡27 745, and $59 194, respectively. According to country-specific willingness to pay thresholds, the ICER of each included study was acceptable. Conclusion Compared to Amiodarone, RFA is a cost-effective therapy for AF.

Citation： ZHONGDai-yun, LIUAi-jun, LUOChu-jun, LIUXiao-qi, ZHANGJian-ping. Pharmacoeconomic Evaluation of Radiofrequency Ablation versus Amiodarone for Atrial Fibrillation. Chinese Journal of Evidence-Based Medicine, 2015, 15(9): 1018-1023. doi: 10.7507/1672-2531.20150170 Copy

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26.	高迎春, 趙平, 賀利平, 等. 陣發性房顫經導管射頻消融與藥物治療的對比評價. 中國循證心血管醫學雜志, 2014, 6(5):555-557.
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1. Naccarelli GV, Varker H, Lin J, et al. Increasing prevalence of atrial fibrillation and flutter in the United States. Am J Cardiol, 2009, 104(11):1534-1539.
2. Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation. Eur Heart J, 2010, 31(19):2369-2429.
3. Fuster V, Rydén LE, Cannom DS, et al. 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines Developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol, 2011, 57(11):101-198.
4. Calkins H, Kuck KH, Cappato R, et al. 2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation:Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design. Heart Rhythm, 2012, 9(4):632-696.
5. Camm AJ, Lip GYH, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation:An update of the 2010 ESC Guidelines for the management of atrial fibrillation Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J, 2012, 33(21):2719-2747.
6. 黃從新, 張澍, 馬長生, 等. 心房顫動:目前的認識和治療建議-2012. 中華心律失常學雜志, 2012, 16(4):246-289.
7. Rodgers M, McKenna C, Palmer S, et al. Curative catheter ablation in atrial fibrillation and typical atrial flutter:systematic review and economic evaluation. Health Technol Assess, 2008, 12(34):1-198.
8. Assasi N, Blackhouse G, Xie F, et al. Ablation procedures for rhythm control in patients with atrial fibrillation:clinical and cost-effectiveness analyses. Ottawa:Canadian Agency for Drugs and Technologies in Health (CADTH), 2010.
9. Papaioannou D, Rafia R, Rathbone J, et al. Rituximab for the first-line treatment of stage Ⅲ-IV follicular lymphoma (review of Technology Appraisal No. 110):a systematic review and economic evaluation. Health Technol Assess, 2012, 16 (37):1-253.
10. McKenna C, Palmer S, Rodgers M, et al. Cost-effectiveness of radiofrequency catheter ablation for the treatment of atrial fibrillation in the United Kingdom. Heart, 2009, 95(7):542-549.
11. Chan PS, Vijan S, Morady F, et al. Cost-effectiveness of radiofrequency catheter ablation for atrial fibrillation. J Am Coll Cardiol, 2006, 47(12):2513-2520.
12. Blackhouse G, Assasi N, Xie F, et al. Cost-Effectiveness of Catheter Ablation for Rhythm Control of Atrial Fibrillation. Int J Vasc Med, 2013, 31(28):1-13.
13. Krittayaphong R, Raungrattanaamporn O, Bhuripanyo K, et al. A randomized clinical trial of the efficacy of radiofrequency catheter ablation and amiodarone in the treatment of symptomatic atrial fibrillation. J Med Assoc Thai, 2003, 86(Suppl 1):S8-16.
14. Pappone C, Augello G, Sala S, et al. A randomised trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation. J Am Coll Cardiol, 2006, 48(11):2340-2347.
15. Wazni OM, Marrouche NF, Martin DO, et al. Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation:a randomized trial. JAMA, 2005, 293(21):2634-2640.
16. Bertaglia E, Stabile G, Senatore G, et al. A prospective, randomized, and controlled study on effect of Catheter Ablation for the Cure of Atrial Fibrillation Study. American College of Cardiology Annual Synposium; Orlando, 2005.
17. Forleo GB, Mantica M, deLucaetal L. Catheter ablation of atrial fibrillation in patients with diabetes mellitus type 2:results from a randomized study comparing pulmonary vein isolation versus antiarrhythmic drug therapy. J Cardiovasc Electrophysiol, 2009, 20(1):22-28.
18. Jais P, Cauchemez B, Macle L, et al. Catheter ablation versus antiarrhythmic drugs for atrial fibrillation:the A4 study. Circulation, 2009, 118(24):2498-2550.
19. Wilber DJ, Pappone C, Neuziletal P. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation:a randomized controlled trial. J Am Med Assoc, 2010, 303(4):333-340.
20. Department of Health. Reference costs. Leeds:DH, 2005.
21. Stewart S, Murphy N, Walker A, et al. Cost of an emerging epidemic:an economic analysis of atrial fibrillation in the UK. Heart, 2004, 90(3):286-292.
22. Khaykin Y, Morillo CA, Skanes AC, et al. Cost comparison of catheter ablation and medical therapy in atrial fibrillation. J Cardiovasc Electrophysiol, 2007, 18(9):907-913.
23. Ontario Case Costing Initiative (OCCI), OCCI Costing Analysis Tool, Ontario Case Costing Initiative, Toronto, Canada, 2010.
24. National Institute for Clinical Excellence. Guidance to the methods of technology appraisal. National Institute for Clinical Excellence (NICE), 2004.
25. 宗欣, 孫利華. 從多國視角看成本效果閾值的應用現狀. 中國藥事, 2011, 25(8):768-771.
26. 高迎春, 趙平, 賀利平, 等. 陣發性房顫經導管射頻消融與藥物治療的對比評價. 中國循證心血管醫學雜志, 2014, 6(5):555-557.
27. 《中國藥物經濟學評價指南》課題組. 中國藥物經濟學評價指南(2011版). 中國藥物經濟學, 2011, 6(3):6-47.

Chinese Journal of Evidence-Based Medicine

Pharmacoeconomic Evaluation of Radiofrequency Ablation versus Amiodarone for Atrial Fibrillation

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