When someone gets diagnosed with atrial fibrillation, a question that is often overlooked in the beginning days is, “How much will living with and managing atrial fibrillation actually cost me?”
Often the out-of-pocket costs can be surprising to my patients, and unfortunately one of the most common conversations I have during appointments is about limiting the financial burden as much as possible.
In terms of expenses- there are two sides to the equation; How much atrial fibrillation costs from a healthcare standpoint, and how much atrial fibrillation costs individual patients.
The number of current patients in the U.S. living with atrial fibrillation is growing rapidly- and current data estimates that as many as 5 million people nationwide are currently affected by AFib.
In 2014, the American College of Cardiology estimated that the total healthcare cost of managing atrial fibrillation totaled 26 billion dollars per year. Wow! For each individual patient, the average out-of-pocket cost was $8,700- also a significant chunk of change.
Taking into account both the increase in number of those diagnosed with AFib and increased inflation- those numbers are both likely to be significantly higher today in 2018. Increases in insurance deductibles and an increase in medicare patients may have also contributed to an increase in this already-high out-of-pocket number.
So then, what is so costly? In my experience, there are two main factors driving costs upwards.
1. Hospital visits
When I meet a new patient effected by atrial fibrillation, one of my first goals is to establish a plan to keep them out of the hospital as much as possible. Not only do patients want to avoid the hospital for comfort reasons, but those bills can add up- and they can add up quickly. If minimizing your out-of-pocket costs is a priority, be sure you’re strategizing with your doctor to come up with a plan of action to do your best to manage your symptoms at home.
Serious conditions that do require hospitalizations, such as strokes, can often be much more costly in patients with AFib due to the severity the condition adds to the health event.
2. Insurance plans
I am seeing more and more patients both on medicare and with high-deductible plans, which can increase out-of-pocket costs. When managing atrial fibrillation, a prescription drug regimen is often necessary, including prescription blood thinners such as Eliquis and Xarelto. It is fortunate that today there are multiple blood thinning options available- some more expensive than others, depending of course on insurance. The newer medications mentioned (also on the list are Pradaxa and Savaysa) are generally more effective than medications of the past since they have an increased consistency in their blood thinning efforts. However, their costs are often a concern.
One of the more frustrating moments I have as a cardiologist is when a patient informs me at their appointment that they have discontinued their medication some time ago because it was too expensive.
A more effective course of action for those unable to afford their medication, and what I try to encourage my patients to do, would be to inform me (or their own doctor) if the prescription drug costs are causing them strain. Without this knowledge, doctors cannot present their patients with all of the available options options nor can they educate on the assistance programs available to them.
These programs can significantly decrease your out-of-pocket costs, especially if your needs are short-term. If you are going through a temporary period of higher-than-normal out-of-pocket costs, these programs can provide you assistance through avenues such as samples, to help get you through the timeframe without becoming too burdened financially.
3. What can you do about your prescription drug costs?
If you have questions about these assistance programs or are concerned about your out-of-pocket costs, I have listed the numbers for each prescription drug below, and as always I encourage you to have a conversation with your doctor.
Assistance Programs Currently Available: