Model input | AAD therapy | Ablation therapy | Distribution | Data source |
Probability of death per cycle | 0.839% | 0.814% | Beta | Weighted average of RCTs |
Initial ablation operative mortality | n/a | 1% | Beta | RCTs |
Pooled mean age | 66 | 66 | n/a | RCTs |
Probability of transition to ‘readmission’ per cycle | 1.666% | 1.332% | Beta | Weighted average of RCTs |
Probability of transition from ‘readmission’ to ‘repeat ablation’ per cycle | 25% | 19% | Beta | Large registry |
Cost of initial strategy | £68 | £8124 | Gamma | Internal audit data, NHS and British National FormularyNF reference costs |
Cost of maintenance of therapy per cycle* | £49 | £10 | Gamma | RCT and British National Formulary |
Cost of repeat ablation/switch to ablation | £8176 | £8176 | Gamma | Internal audit data |
Cost of readmission | £2072 | £2072 | Gamma | Retrospective cohort study, NHS reference costs |
Utility at baseline | 0.781 | 0.771 | Beta | RCTs |
Disutility of readmission | −0.02 | −0.02 | Beta | From review article and cohort study |
Disutility of reablation | −0.04 | −0.04 | Beta | Registry |
Disutility of reablation with adverse event | −0.13 | −0.13 | Beta | Registry, review article |
Disutility of AAD with adverse event† | −0.06 | −0.06 | Beta | RCT |
Discount | 3.5% | 3.5% | n/a | NICE |
*Assume 20% of ablation arm also on amiodarone.
†Assume 1.29% rate per cycle of adverse event (AE). Costs are in UK sterling as of 2018.
AAD, antiarrhythmic drug; n/a, not applicable; NHS, National Health Service; NICE, National Institute for Health and Care Excellence; RCT, randomised clinical trial.