Estimation of total incremental health care costs in patients with atrial fibrillation in the united states

Michael H. Kim, Stephen S. Johnston, Bong Chul Chu, Mehul R. Dalal, Kathy L. Schulman

Research output: Contribution to journalArticlepeer-review

535 Scopus citations


Background: Detailed information on the cost burden of atrial fibrillation (AF) is limitedTo provide an up-to-date estimate of the national cost of AF, we conducted a retrospective, observational cohort study using administrative claims from the MarketScan Commercial and Medicare Supplemental research data bases, 2004 to 2006Methods and Results: Patients aged ≥20 years with ≥1 inpatient or ≥2 outpatient AF diagnoses in 2005 (first diagnosis=index) and ≥12 months' enrollment before and after index were selectedAF patients were propensity score-matched (1:1) with non-AF control subjectsMedical costs (2008 US$), including AF costs, other cardiovascular, and noncardiovascular costs, were examined over 1 year after indexNational incremental costs of AF were based on age-/sex-specific AF prevalence projections for 2010In total, 89 066 AF patients were matched to non-AF control subjectsOver 1 year, 37.5% of AF versus 17.5% of control subjects were hospitalized and 2.1% versus 0.1% died during hospitalizationFor AF versus control subjects, mean annual inpatient costs per patient were $7841 versus $2622 (incremental cost, $5218), outpatient medical costs were $9225 versus $5629 ($3596), and outpatient pharmacy costs were $3605 versus $3714 (-$109) (all P<0.001)The total incremental cost of AF was $8705 per patientThe national incremental cost of AF was $26.0 billion (AF, $6.0 billion; other cardiovascular, $9.9 billion; noncardiovascular, $10.1 billion)Cardiovascular costs were based on claims with a primary disease diagnosis and may be underestimatesConclusions: On the basis of current US age- and sex-specific prevalence data, the national incremental AF cost is estimated to range from $6.0 to $26.0 billion.

Original languageEnglish (US)
Pages (from-to)313-320
Number of pages8
JournalCirculation: Cardiovascular Quality and Outcomes
Issue number3
StatePublished - May 2011
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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