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The economic burden attributable to atrial fibrillation in nine European countries: perspectives from the GARFIELD-AF registry

Session Poster Session 3

Speaker Mr Paolo Cozzolino

Event : ESC Congress 2018

  • Topic : arrhythmias and device therapy
  • Sub-topic : Epidemiology, Prognosis, Outcome
  • Session type : Poster Session

Authors : P Cozzolino (Monza,IT), G Ambrosio (Perugia,IT), J-P Bassand (Besancon,FR), H T Cate (Maastricht,NL), F Cools (Brasschaat,BE), H Darius (Berlin,DE), D A Fitzmaurice (Coventry,GB), S Haas (Munich,DE), J-Y Leheuzey (Paris,FR), G Agnelli (Perugia,IT), M Rosenkvist (Stockholm,SE), J Stepinska (Warsaw,PL), X Vinolas (Barcelona,ES), L G Mantovani (Monza,IT), A K Kakkar (London,GB)

P. Cozzolino1 , G. Ambrosio2 , J.-P. Bassand3 , H.T. Cate4 , F. Cools5 , H. Darius6 , D.A. Fitzmaurice7 , S. Haas8 , J.-Y. Leheuzey9 , G. Agnelli10 , M. Rosenkvist11 , J. Stepinska12 , X. Vinolas13 , L.G. Mantovani1 , A.K. Kakkar14 , 1University of Milan Bicocca - Monza - Italy , 2University of Perugia School of Medicine - Perugia - Italy , 3Thrombosis Research Institute, London, UK & University of Besançon - Besancon - France , 4Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre - Maastricht - Netherlands , 5AZ KLINA Cardiology - Brasschaat - Belgium , 6Vivantes Neukoelln Medical Center - Berlin - Germany , 7University of Warwick Medical School - Coventry - United Kingdom , 8Formerly Department of Medicine, Technical University of Munich - Munich - Germany , 9Georges Pompidou Hospital, René Descartes University - Paris - France , 10Azienda Ospedaliera di Perugia Medicina Interna e Vascolare Stroke Unit - Perugia - Italy , 11Södersjukhuset, vo Kardiologi Karolinska Institutet, Institutionen för klinisk forskning och utb - Stockholm - Sweden , 12Institute of Cardiology - Warsaw - Poland , 13Hospital Santa Creu y San Pau Servicio de Cardiologia - Barcelona - Spain , 14Thrombosis Research Institute and University College London - London - United Kingdom ,

On behalf: GARFIELD-AF Investigators

Atrial Fibrillation - Epidemiology, Prognosis, Outcome

European Heart Journal ( 2018 ) 39 ( Supplement ), 607-608

Background: We evaluated the economic burden of atrial fibrillation (AF) in nine European countries (Belgium, France, Germany, Italy, Netherlands, Poland, Spain, Sweden and UK).

Methods: Data were gathered from GARFIELD–AF, a prospective, global registry of adults with newly (<6 weeks) diagnosed AF and ≥1 stroke risk factor(s). Total annual direct costs due to AF were the sum costs of: medical visits, drug therapy, hospital admissions, diagnostic procedures, and other medical events due to AF. Direct unit costs were quantified based on days on drug therapy and events recorded in GARFIELD-AF. Varying lengths of follow-up were considered using Bang and Tsiatis method to handle censored cost data. Mean cost per patient/year was expressed as absolute cost (€) and as a percentage of the country-specific healthcare expenditure per capita.

Results: Data were collated from 20,074 patients; median follow-up 1.97 years and 42,435 person-years of observations. Highest expenditure was observed in Belgium and UK (€ 3473 and € 2712, respectively); Table 1. Poland, with the smallest total cost per patient/year, had the highest healthcare expenditure per capita (105%). Inpatient care was the main cost in all countries, ranging between 48% of the total costs (France and Sweden) and 71% (Belgium and Germany); Fig.1. Outpatient costs varied between 7% of the total cost (Poland) and 32% (Netherlands). Different treatment combinations are likely to be responsible for variations in drug treatment costs.

Conclusions: AF is gaining increasing importance as a public health problem. The economic burden correlates with differences in management between countries. Inpatient care represents the largest part of the total care costs in all countries. Further stratification of patients (e.g. using risk scores) may improve our understanding of the healthcare expenditure associated with AF.

Country-specific mean cost per patient/y
CountryNMean cost (€)95% Confidence Interval
Belgium171134733185 to 3761
France179816701524 to 1815
Germany353818801746 to 2014
Italy218113451194 to 1496
Netherlands118516001394 to 1806
Poland2428790749 to 831
Spain243916651483 to 1846
Sweden122721611973 to 2349
UK356727122494 to 2930
Cost share observed by country

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