Cost-effectiveness analysis of propafenone compared to amiodarone in the treatment of acute atrial fibrillation in patients without structural heart disease from the Brazilian Public Health System perspective

Abstract

Objectives: To perform a cost-effectiveness analysis of propafenone (Ritmonorm®) versus amiodarone in atrial fibrillation patients without structural heart disease in Brazilian Public Healthcare System. Methods: The study was a cost-effectiveness analysis based on a one-year Markov modeling. Epidemiological and efficacy data derived from a critical appraisal of the scientific literature. Costs and benefits were discounted at 5% yearly. Only direct medical costs were used. Outcomes were expressed as hospital admission avoided. Probabilistic sensitivity analysis was conducted to assess model robustness. Results: The economic analysis suggests that propafenone provides economy with less hospital admission when compared with amiodarone (-0.61 hospital admission/patient and -BRL100.07/patient). This analysis suggests that propafenone is more effective and also less expensive compared to amiodarone. The budget impact analysis shows that a reduction of approximately BRL 25 million a year was estimated with the incorporation of propafenone into treatment of target population studied in public healthcare system. Conclusion: This study demonstrates that propafenone is a better treatment option because of the lower cost and superior efficacy compared to amiodarone, being classified as cost-saving.