Healthcare Expenditure on Atrial Fibrillation in the United States

BACKGROUND: Atrial fibrillation (AF) prevalence is increasing, and management is evolving. This study builds on prior studies focusing on AF healthcare expenditures. OBJECTIVES: The purpose of this study was to provide a contemporary nationally representative assessment of AF and atrial flutter expenditures in the United States. METHODS: Using Medical Expenditure Panel Survey 2016 to 2021 data, we identified individuals with AF or atrial flutter using International Classification of Disease-10 codes and reported total and categorized expenditures. Using 2-part and gamma regression models, respectively, we estimated the incremental AF expenditures for the entire population and for individuals with common coexisting comorbidities. Among AF individuals, we identified characteristics associated with higher expenditures. RESULTS: Of a weighted surveyed population of 248,067,064 adults, 3,564,763 (1.4%) had AF, with a mean age 71.9 ± 10.6 years, and 45.7% were female. The mean unadjusted annual total healthcare expenditure was $25,451 ± $1,100 ($9,254 ± $82 without AF). Highest spending categories were inpatient visits ($7,975 ± $733) and prescriptions ($6,505 ± $372). AF expenditures increased over the study period by 11.1%. After adjustment, the incremental annual expenditure attributable to AF was $6,185 per person. Incremental AF expenditures were highest for those with cancer at $12,052 ($4,476-$19,627), while AF did not significantly increase expenditures in heart failure at $30 (-$7,660 to $7,716). Cancer, modified Charlson Comorbidity Index of 1 or ≥2, chronic kidney disease, type 2 diabetes mellitus, chronic obstructive pulmonary disease, atherosclerotic cardiovascular disease, poor income level, bachelor's degree, and later survey year were associated with higher expenditures. CONCLUSIONS: AF is associated with substantial and increasing healthcare expenditures. With changing screening and management, expenditures need periodic reassessments.