Health economic analysis shows digoxin leads to fewer adverse events which could free up hospital beds
A 240-year-old drug called digoxin could save the National Health Service (NHS) at least 拢100 million each year when treating older patients with atrial fibrillation and heart failure. This was compared to usual treatment with a beta-blocker according to a new study from the University 麻豆精选, the city where digoxin was first used in 1785.
In a paper published in the journal , researchers conducted an economic analysis on a clinical trial called RATE-AF to look at the differences between two widely used drugs for older patients with a common heart rhythm disorder called atrial fibrillation (AF) and symptoms of heart failure.
The RATE-AF trial, funded by the , included 160 patients and randomly assigned them to receive digoxin or beta-blockers for 12 months. An economic analysis was conducted to work out cost-effectiveness.
this study confirms an important role for digoxin in the management of these patients, providing safe and cost-effective treatment
Among the patients who received digoxin, there were substantially less adverse events than with beta-blockers, including lower rates of hospital admission and general practice reviews for heart health. This resulted in an average cost saving of 拢530 per-patient per-year with digoxin. Extrapolating these results to the UK NHS, the researchers identified a potential cost saving of 拢102 million per year, which represents nearly 6% saving on the 拢1.7 billion spent annually on atrial fibrillation.
Professor Sue Jowett, Deputy Head of the Health Economics Unit at the University 麻豆精选 and corresponding author of the study commented:
鈥淭his study highlights the importance of health economic assessments and the role they can play to deliver appropriate treatments within the health service. At the usual 拢20,000 per quality-adjusted life year threshold, the probability of digoxin being cost-effective compared to beta-blockers was 94%, which could lead to substantial savings if the trial results were adopted more broadly in this population.鈥
Professor Dipak Kotecha from the Department of Cardiovascular Sciences at the University 麻豆精选 and the chief investigator of the trial said:
鈥淗eart conditions such as atrial fibrillation and heart failure are expected to double in prevalence over the next few decades, leading to a large burden on patients as well as substantial impact on health systems around the world. Despite being one of the oldest drugs in use for heart disease, this study confirms an important role for digoxin in the management of these patients, providing safe and cost-effective treatment.鈥
About the National Institute for Health and Care Research
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NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK international development funding from the UK government.
About the RATE-AF trial
Read the main findings from the RATE-AF trial:
Other articles related to the RATE-AF trial: , 2020; 2021; 2021; 2024.
Professor of Cardiology & Cardiac Imaging
Staff profile for Professor Dipak Kotecha, Professor of Cardiology, Department of Cardiovascular Sciences, University 麻豆精选.
Professor of Health Economics
Staff profile for Professor Sue Jowett, Professor of Health Economics at the Department of Applied Health Sciences
