Cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in low surgical risk aortic stenosis patients

Cost-Effectiveness of SAPIEN 3 Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in German Severe Aortic Stenosis Patients at Low Surgical Mortality Risk

“…As such, accounting only for differences in model structure and utilities, it is only feasible to compare the incremental QALYs at 1 year between the two models, which were 0.1 and 0.05, respectively, so actually even more conservative in the German model. Similarly, costeffectiveness analyses using the same model have been run in France, Italy, and Spain, which The overall cost-effectiveness of TAVI with SAPIEN 3 in low-risk patients in Germany appears to be driven by lower long-term management costs, particularly those associated with treating AF and disabling stroke; cost savings in these areas were also seen in the studies in France and Italy [7,8]. Our analysis showed that initial procedure costs for TAVI with SAPIEN 3 were higher than for SAVR in Germany; this was also the case in Italy [8], whereas the initial cost for performing TAVI was lower than for SAVR in France [7].…”

“…Given the maturity of TAVI technology, the demonstrated clinical benefits for patients, the high numbers of procedures already performed, and the huge potential for further adoption with the move towards use in lower-risk patients wherein SAVR is more likely to have a favorable outcome, it is increasingly important to demonstrate the cost-effectiveness of TAVI in Germany. Using the same model as in our analyses, authors have previously shown TAVI to be cost-effective versus SAVR in low-risk patients with sSAS in France, Italy, and Spain [7][8][9]. Here, we report the first ever cost-utility analysis of TAVI with SAPIEN 3 versus SAVR from a German perspective in patients with sSAS at low risk of surgical mortality.…”

Incorporating economic analysis in interventional cardiology research

“…Historically, the willingness to pay threshold in the United States has been $50,000 per QALY (based on the historical benefit of dialysis in adults with chronic renal insufficiency), though that has been questioned recently 55 . Willingness to pay varies broadly between countries (as do local costs for good and services), which has fueled parallel analyses of cost‐effectiveness in different countries 6,7,9,10,56–67 …”

“…These analyses are important because they can allow for identification of which aspects of each strategy drive differences in cost‐effectiveness and how much change would have to occur for the strategy to reflect good value. This type of analysis is also critically important to determine whether the results of one strategy are transmissible to other contexts where either outcomes or willingness to pay may differ significantly 6,7,9,10,56–67 …”

A European update on transcatheter aortic valve implantation (TAVI) in the COVID era

“…Transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR) is fast emerging as an alternative intervention for this patient cohort. TAVI or TAVR is a minimally invasive, cost‐effective (Mennini et al, 2022; Reynolds et al, 2012; Watt et al, 2012), a procedure wherein a prosthetic valve is implanted within the existing native aortic valve, without removal of the old damaged tissue. The new prosthetic valve is typically deployed via the transfemoral route, though other approaches include transapical, subclavian, direct aortic, and transcaval access.…”