PO-03-154 AN ANALYSIS OF THE PATIENT-INCURRED COSTS ASSOCIATED WITH DEVICE-DETECTED ATRIAL FIBRILLATION

Abstract

Atrial fibrillation (AF) diagnosis is associated with increased healthcare costs. However, current estimates of this increased cost may be confounded by AF-related comorbidities. To date, there are limited data on incremental costs that patients incur as a direct result of AF. To assess for associations between device detected AF (ddAF), and patient-incurred healthcare costs. Using the de-identified Optum® Clinformatics® U.S. claims database (2015 to 2020) linked with the Medtronic CareLink® database, we identified CIED patients that transmitted data ≥6 months post-implant (baseline period). Annualized patient-incurred costs during follow-up, adjusted to 2020 US Dollars were compared between patients with no AF and those with device detected paroxysmal AF (pAF), persistent AF (PeAF) and permanent AF (PermAF). Analyses were adjusted for geographical region, insurance type, CHA2DS2-VASc Score, and implant year. Of the 21,391 patients (72.9±10.9 yrs; 56.3% male) analyzed, 7,798 (36.5%) had ddAF. Among those with ddAF, 5,966 (76.5%) were pAF (avg burden 2.9±8.6%), 1,145 (14.7%) were PeAF (avg burden 47.2±29.9%), and 687 (8.8%) were PermAF (avg burden 99.3±0.7%). Patients with ddAF had higher annualized patient-incurred healthcare costs than those without ddAF (fig). The incremental patient-incurred cost in those with ddAF is $290 ± $4,126 per patient annually. Patients with pAF, PeAF and PermAF all had higher patient-incurred adjusted healthcare costs than those without AF (p for all <0.001). While patients with PeAF and PermAF had higher patient-incurred adjusted healthcare cost ratios than patients with pAF, there was no statistically significant difference in costs between patients with PeAF and PermAF (Fig). Compared to those without ddAF, patients with ddAF incurred higher annual healthcare costs after adjustment for clinical and demographic covariates. Furthermore, among patients with ddAF, those with PeAF and PermAF incurred greater costs than patients with pAF. These results speak to the incremental financial impact of AF diagnosis and the potential monetary benefit of strategies to prevent the onset or progression of AF.