A5

By ADAM BOWIE
bowie.adam@dailygleaner.com

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Local cardiologists are excited to learn more about a new treatment for atrial fibrillation that was recently approved by Health Canada.

Multaq, or dronedarone, has been approved for use in Canada, but the cost of the drug won't be covered until individual provinces add it to the list of drugs on their formularies.

An Ontario study says that about 250,000 Canadians suffer from an irregular or rapid heartbeat, which can lead to more serious conditions such as heart failure or strokes.

The study says atrial fibrillation causes about 43,000 hospitalizations per year in Canada - costing the health-care system more than $222 million.

Dr. Nick Giacomantonio, a cardiologist and expert on atrial fibrillation who works at the QEII Health Sciences Centre in Halifax, said an aging population will make the condition more prevalent in the next few years.

Giacomantonio said he'll be able to prescribe dronedarone with his patients, but only if they're willing to cover the costs of the medication.

"I can use it as a treatment, but the patient has to pay for it," he said.

"It's legally approved, but because there's no coverage, the patient has to say, 'I believe in this drug, and I have the ability, so I will pay for it.'"

He said the medication will provide the same benefits as a drug called amiodarone but will have fewer side effects and should eventually help reduce the strain on the health-care system caused by unnecessary hospitalizations.

"It has at least the same benefit as amiodarone, with respect to decreasing recurrent rhythm problems," he said.

"So because it has a clinical trial that demonstrated significant reductions in the combined endpoints of hospitalizations and mortality, that makes it a valuable therapy.

"That's because hospitalizations cost a lot more than the drug will cost."

Dr. Rob Stevenson, a cardiologist from Jemseg, said he's looking forward to learning more about dronedarone because there haven't been many treatment options available in the past.

"Even though you have a relative minority of people with the problem as opposed to coronary artery disease, atrial fibrillation is the cause of morbidity and mortality for a significant population," he said.

"In that group of patients, we've had relatively few options for treatment. When you're dealing with these people on a day-to-day basis, you'd like to be able to provide a reasonable therapy for them. What we have currently works for some, but not for all."

Stevenson said it'll also be important to monitor how the new drug reacts with the body over an extended period of time.

"Any new medication is welcomed for consideration. However, what we'll always be looking at is the long-term effects of these medications," he said.

"When a new medication is introduced, as good as its purported to be, the onus is always on us physicians to ensure that the benefit of the medication, in both the short- and the long-term, is better than the current treatments available."

Giacomantonio said he'll be researching dronedarone through clinical trials and gathering evidence as to why provinces should consider covering the new medication.

"That's what we need to do now. Is it cost effective? And does it work in the real world?" he said.

"The next stepping stone is to find out if individual provinces think this therapy is worthwhile."