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University of Birmingham Study Reveals Economic Benefits of Digoxin in Treating Atrial Fibrillation and Heart Failure
A groundbreaking study has revealed that digoxin, a drug first used in 1785, could save the UK’s National Health Service (NHS) up to £100 million annually in the treatment of older patients with atrial fibrillation (AF) and heart failure. The findings, published in the prestigious journal Heart, compare digoxin’s cost-effectiveness with that of beta-blockers, a commonly used treatment for these heart conditions.
Conducted by researchers at the University of Birmingham, where digoxin was first used in clinical practice, the study examined data from the RATE-AF trial. This trial, which involved 160 patients with atrial fibrillation and symptoms of heart failure, compared the impact of digoxin and beta-blockers over a 12-month period.
The analysis showed that patients treated with digoxin experienced fewer adverse events, including fewer hospital admissions and general practice visits for heart health concerns. As a result, digoxin offered a substantial cost-saving benefit, with an average reduction of £530 per patient per year.
Extrapolating these results, the study estimates that the NHS could save as much as £102 million annually, which represents nearly 6% of the £1.7 billion spent each year on atrial fibrillation treatments in the UK.
Professor Sue Jowett, Deputy Head of the Health Economics Unit at the University of Birmingham and corresponding author of the study, commented, “This study highlights the importance of health economic assessments and their role in delivering cost-effective treatments within the NHS.”
With a 94% probability of digoxin being cost-effective compared to beta-blockers, according to the study’s findings, these results could potentially lead to significant financial savings if adopted across the healthcare system.
Professor Dipak Kotecha, Chief Investigator of the trial and expert in cardiovascular sciences at the University of Birmingham, emphasized the growing impact of heart conditions such as atrial fibrillation and heart failure. “These conditions are expected to double in prevalence over the next few decades, which will place a large burden on both patients and healthcare systems worldwide,” he explained. “Despite being one of the oldest drugs in use for heart disease, this study reinforces the significant role digoxin can play in providing safe and cost-effective treatment.”
The study’s results suggest that digoxin, often overshadowed by newer medications, could be an essential tool in managing heart rhythm disorders and addressing the financial challenges faced by healthcare systems like the NHS.
Disclaimer: The findings of this study are based on a specific patient cohort, and further research may be needed to fully understand the broader implications for all patients with atrial fibrillation and heart failure. The cost-effectiveness analysis is based on available data and may vary based on individual circumstances and healthcare settings.
For more information, refer to the study published in Heart: Zainab Abdali et al, Cost-effectiveness of digoxin versus beta-blockers in permanent atrial fibrillation: the Rate Control Therapy Evaluation in Permanent Atrial Fibrillation (RATE-AF) randomised trial, Heart (2025). DOI: 10.1136/heartjnl-2024-324761.
