Cost of illness and drivers of cost in atrial fibrillation in Sweden and Germany.

BACKGROUND: Atrial fibrillation (AF) is an important public health problem in European countries. AF is associated with increased morbidity and mortality, e.g. from heart failure and thromboembolic events. Little data have previously been presented regarding the costs of treatment in patients with AF. OBJECTIVE: To estimate total direct and indirect costs in patients with AF in Sweden and Germany, and to identify determinants of total costs. METHODS: A cross-sectional observational study was conducted through surveys to patients and their treating physician in primary care and in hospital outpatient cardiology departments in Sweden and Germany. A total of 922 patients with AF as diagnosed in clinical practice were enrolled and completed the study. Data were collected on medical history, treatment, medical and non-medical resource use, and employment status. Costs (year 2005 values) were calculated by multiplying resources used with prices specific for Sweden and Germany, respectively. RESULTS: Total annual costs per patient were €7241 in Sweden and €5586 in Germany. Slightly less than 70% of total costs were judged as being AF related in both countries. Costs of AF-related medication were about 2% of total costs in both countries. In a generalized regression model, costs were found to increase with age, but were lower in patients aged>65 years than in those aged

Pharmacological rhythm and rate control treatment for atrial fibrillation: patient and physician satisfaction.

OBJECTIVE: : Atrial fibrillation (AF) represents a significant burden on healthcare resources. This study aimed to (i) identify key determinants for treatment choices in AF; (ii) analyze impacts of AF treatment on patient satisfaction and compliance; and (iii) analyze impacts of AF treatment on physician satisfaction and willingness to prescribe. METHODS: : Physicians and their patients with paroxysmal, persistent, and permanent AF were recruited and asked to respond to questionnaires. Patient and physician satisfaction was analyzed by specifying structural models with latent variables, using partial least squares (PLS) to estimate the models. RESULTS: : Physician satisfaction with available AF treatment was low (55 ± 1.3; p = 0.1, on a scale of 0-100), but physician willingness to prescribe in AF was high. AF patient satisfaction with current treatment was low (71 ± 1.2; p = 0.1), but despite this, their treatment compliance was rated as high (90 ± 0.9; p = 0.1). CONCLUSION: : The satisfaction with current AF treatment was low in patients with AF. Physician satisfaction with available AF drugs was driven by efficacy. The same appeared to be true for the patients - satisfaction, compliance, and functional ability would most likely increase with a perceived better drug efficacy.