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Cost-effectiveness of transcatheter Aortic valve implantation in patients At intermediate surgical risk

KEY MESSAGES

TAVI in intermediate risk severe aortic stenosis patients was found to be associated with lower cost compared to SAVR.

tavi cost

Additional quality-adjusted life years (QALY) gain and cost-effectiveness of TAVI vs. SAVR depends on long-term survival, with several scenarios being explored.

Additional analyses, with longer-term survival data, is needed to draw any definitive conclusions about long-term cost-effectiveness.

A Model-based Analysis, Based on the SURTAVI Trial, Using Contemporary Cost Data

OVERVIEW OF METHODS

  • The goal is to explore costs and effectiveness of TAVI vs. SAVR in severe aortic stenosis patients (AS) at intermediate surgical risk
  • Uses contemporary USA cost data
  • Mortality, clinical event rates, and rehabilitation resource utilization derived from SURTAVI trial
  • Costs were derived from real-world claims data from USA Medicare population in 2017 (index procedure and adverse events) and Medicare fee payment schedules (proxy for rehabilitation and long-term follow-up costs). All costs were inflated to 2018 costs using medical consumer price index
  • Costs and effectiveness as QALYs were projected to lifetime via a Markov model calibrated to 24-mo. incidences of all-cause mortality and stroke

SELECTED CLINICAL RESULTS

results

Other Adverse event Results

  • Similar rates to SAVR of life-threatening/disabling bleed
  • TAVI had higher rates of major vascular complications (s.) and new permanent pacemaker/ICDs (s.)
  • Impact on QALYs differs based on the long-term mortality scenario used
  • Long-term cost-effectiveness requires additional analyses with longer-term survival data

s. = statistically significant
n.s. = not statistically significant

Reference:

Reardon et al (2019, May). Cost-effectiveness of Transcatheter Aortic Valve Implantation in Patients at Intermediate Surgical Risk: A Model-based Analysis based on the SURTAVI Trial Using Contemporary Cost Data. Poster session presented at EuroPCR 2019, the annual Course of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the European Society of Cardiology (ESC), Paris, France.

CAUTION: For distribution only in markets where CoreValve™ Evolut™ R and CoreValve™ Evolut™ PRO Systems are approved.

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