A historic heart medication has emerged as a cost-effective alternative in treating heart failure, according to new research from the University of Birmingham. The study reveals that digoxin, a drug with roots dating back to 1785, could generate substantial cost savings for the UK's National Health Service (NHS) while effectively managing heart failure in elderly patients with atrial fibrillation (AF).
Clinical Trial Findings and Economic Impact
The RATE-AF trial, funded by the National Institute for Health and Care Research, enrolled 160 participants who were randomly assigned to receive either digoxin or beta-blockers over a 12-month period. The health economic analysis revealed significant advantages for digoxin treatment, including reduced hospital admissions and fewer general practice consultations for cardiac issues.
The economic benefits are substantial, with digoxin treatment saving an average of £530 per patient annually. When extrapolated across the NHS, this could amount to annual savings of £102 million, representing nearly 6% of the £1.7 billion currently spent on AF management in the UK.
Statistical Significance and Cost-Effectiveness
Sue Jowett, deputy head of the University of Birmingham Health Economics Unit and the study's corresponding author, emphasized the significance of the findings: "At the usual £20,000 per quality-adjusted life year threshold, the probability of digoxin being cost-effective compared to beta-blockers was 94%."
Clinical Implications and Patient Benefits
The study's results suggest a potential shift in treatment approaches for elderly patients with heart failure and AF. Beyond the economic advantages, the research demonstrated that digoxin treatment led to:
- Decreased frequency of hospital admissions
- Reduced need for general practice reviews
- Fewer adverse events compared to beta-blockers
This comprehensive evaluation indicates that digoxin could offer a more sustainable and efficient treatment option while maintaining effective patient care standards.
