If you have atrial fibrillation (or AF), your treatment can help reduce your risk of stroke. However, it can be expensive—even if you have health insurance.
Research suggests that you are more likely to need medical care (especially in the year after your diagnosis) than people without the condition. In addition, you are more likely to experience twice the number of hospitalisations than people without the condition.
As the incidence of AF increases, understanding the costs involved can be helpful. By knowing what your insurance covers and how to get help with treatment costs, you can be better prepared for whatsoever the future may bring.
A Snapshot of Afib Costs
A report examined the amount of money you may have to pay for AF treatment. In the first year after diagnosis, people with the condition:
On average, people with AF visit the doctor nine times more often than people without AF. They visited the emergency room, had to be hospitalised, and took more prescription medications than those without AF. In addition, they had average out-of-pocket expenses of $2,106—compared to $877 for people without AF.
They incurred an average medical expense of $23,306. This is compared to $4,839 for individuals without AF. In another study, the average total health care expense for people with AF was $27,896, which was higher than for those without the condition.
They visited the doctor less often if they lived in rural areas. However, they had a higher number of urgent care visits and took more medications.
Diagnostic Procedures
Your doctor will likely order one or more tests to diagnose AF, in addition to reviewing your symptoms and medical history and execution a physical exam. These tests may include:
An electrocardiogram (ECG or EKG). An EKG records electrical signals using sensors attached to your chest and arms. It creates a graphic representation as electrical impulses travel through the heart muscle. Cost: $100–$300.
Holter monitor. This portable device is worn in a pocket, on a belt, or on a bear strap for 1 to 3 days. It features wires and electrodes that are attached to the chest. It allows your doctor to check your heart rhythm. Cost: $110–$1,300.
Portable Event Monitor. If you have a persistent irregular heart rhythm, your doctor may ask you to wear a portable ECG device for about a month. If you experience symptoms, press a button. At that time, the monitor will record your heart’s electrical activity and send the data through phone lines to your doctor’s office. Cost: $284–$783.
Echocardiogram. A technician will place a wand-like device on your chest to emit sound waves and take real-time images of your heart as it pumps. Cost: $1,000–$3,000.
Other Tests: These include blood tests, stress tests ($1,100–$2,775), and chest X-rays ($110–$270).
All prices listed represent costs without health insurance. They were compiled at the time of publication.
Your private insurance may cover some or all of the cost of diagnostic tests if your doctor orders them because you are showing signs of atrial fibrillation (AF). Medicare Part B and Medicaid also cover these tests.
A recent study showed that detecting AF using a wearable device may be a more cost-effective alternative to general screening exams. However, it is not considered an official diagnosis; therefore, you will need to undergo additional follow-up tests to confirm the result.
Medications to Restore or Maintain Heart Rhythm
Often, the next step following a diagnosis of atrial fibrillation (AF) may be to restore a normal heart rate and rhythm.
Antiarrhythmic medications are usually the first treatment patients try. Your doctor may recommend medications that are given orally or intravenously (IV) in the hospital. These medications may include:
- Amiodarone: A 30-day supply of a 200-milligram pill costs between $8.64 and $15.63.
(Cordarone, Nexterone, Paceron): $153–$156.76
- Disopyramide: A 30-day supply of 100-milligram capsules costs between $51.49 and $163.26.
(Norpace, Norpace CR) 21 capsules cost between $106.14 and $109.06.
- Dofetilide: A 28-day supply of 250-microgram capsules costs between $24.45 and $172.69.
(Tikosyn): $337.83–$352.58 for 30 capsules.
- Dronedarone (Multaq): No generic available. A 28-day supply of 400-milligram tablets costs between $363.25 and $379.53.
- Flecainide Acetate: No brand-name version available. A 30-day supply of 50-milligram tablets ranges from $10.58 to $32.78.
- Propafenone: A 30-day supply of a 150-milligram pill ranges from $8.22 to $44.31. (Rythmol): $199.93–$206.37
- Sotalol: A 30-day supply of an 80-milligram pill ranges from $5.95 to $20.28.
(Betapace): $512.79–$538.08
Other Medications for AFib
You may also need to take heart rate control medications and anticoagulants (to prevent blood clots that can lead to stroke) while you are being treated for AF. These include:
Heart Rate Control Medications
- Digoxin: A 30-day supply of a 125-microgram tablet costs between $2.58 and $16.12.
(Lanoxin): $225.14–$233.10
- Metoprolol succinate: A 30-day supply of a 25-milligram tablet costs between about $3.07 and $12.42.
(Toprol XL): $44.12–$49.26
- Diltiazem: A 30-day supply of a 240-milligram capsule costs between $4.99 and $18.03.
(Cardizem): $78.35–$81.62
- Verapamil: A 30-day supply of 240-milligram pills costs between $3.35 and $16.32.
(Calan): $274.41–$285.34
Anticoagulants
- Warfarin: A 30-day supply of 5-milligram pills costs between $3.68 and $11.64.
(Coumadin): $75.79–$79.12
- Apixaban (Eliquis): No generic available. A 30-day supply of 5-milligram pills costs between $289.25 and $301.08.
- Dabigatran: The average cost of 60 capsules is between $115.62 and $416.39.
(Pradaxa): $408.96–$428
- Edoxaban (Savaysa): No generic available. A 30-day supply of 60-milligram pills ranges from $397.54 to $415.89.
- Rivaroxaban (Xarelto): A 30-day supply of 20-milligram pills ranges from $550.29 to $629.99.
If another condition puts you at risk for atrial fibrillation (AF), you will also need treatment for that condition. It is difficult to predict the total cost, as it depends on the medications you need, their frequency and dosage, and your insurance coverage. Some research suggests that medical therapy may cost between $4,176 and $5,060 per year.
Procedures for AF
Your doctor may endorse a procedure called electrical cardioversion. This involves using a low-voltage electrical shock to try to restore your heart rhythm. You will be asleep during the procedure.
Like other procedures for AF, electrical cardioversion should be covered by isolated insurance, Medicare, and Medicaid. However, it is advisable to review the costs associated with your deductible, copay, or coinsurance.
Invasive Options
If cardioversion or medications fail to restore your heart rhythm, your doctor may recommend one of several invasive procedures. These include:
Catheter ablation. Your doctor will supplement a long, thin tube from your groin to your heart. The tip of the tube is heated or cooled to destroy the tissue that is causing the irregular heart rhythm.
Maze procedures. Your surgeon creates scar tissue in the heart to disrupt the electrical impulses that cause AF. This can be done using modern techniques that don’t require a scalpel.
Atrioventricular (AV) node ablation. A catheter delivers radiofrequency energy to destroy a small section of tissue along the pathway connecting the upper and lower chambers of the heart.
Left atrial appendage procedure. Your surgeon removes the appendage or closes it with a clip to prevent blood clots from forming.
Pacemaker implantation. Your doctor may suggest this procedure if you have AF along with another arrhythmia. You will also need to take anticoagulant (blood thinner) medications.
Heart surgery is very expensive. For example, one study revealed that the average cost of a catheter ablation is between about $21,000 and $26,000. A pacemaker can cost between $26,000 and $68,000. Your out-of-pocket costs for a procedure can easily exceed your health plan’s annual maximum. You should find out in advance—through your doctor’s office and your insurance company—how much you will have to pay for the procedure.
Conclusion
Helpful tips
If you are concerned about the cost of treatment for AF, many pharmaceutical companies offer programs that provide discounts. Additionally, participating in a clinical trial can significantly reduce the cost of your treatment. Clinical trials test new treatments to determine their effectiveness and potential side effects. Your doctor can help you find a scientific trial that may be right for you.