The cost-effectiveness of transcatheter aortic valve implantation: exploring the Italian National Health System perspective and different patient risk groups

• DOI: 10.1007/s10198-021-01314-z
• Publication Date: 2021-05-21T09:04:25Z
• Authors: V. Lorenzoni; G. Barbieri; F. Saia; F. Meucci; G. L. Martinelli; A. G. Cerillo; S. Berti; P. Candolfi; G. Turchetti
• Keywords: Incremental cost-effectiveness ratio; Cost–utility analysis

To assess the cost-effectiveness (CE) of transcatheter aortic valve implantation (TAVI) in Italy, considering patient groups with different surgical risk.A Markov model a 1-month cycle length, comprising eight health states, defined by New York Heart Association functional classes (NYHA I-IV), and without stroke plus death, was used to estimate CE TAVI for intermediate-, high-risk inoperable patients replacement or medical treatment as comparators according group. The Italian National Health System perspective 15-year time horizon were considered. In base-case analysis, effectiveness data retrieved from published efficacy total direct costs (euros) estimated national tariffs. A scenario analysis micro-costing approach procedural also incremental ratio (ICER) expressed both terms per life years gained (LYG) quality adjusted (QALY). All outcomes discounted at 3% annum. Univariate probabilistic sensitivity analyses (PSA) performed robustness results.Over horizon, higher acquisition partially offset all risk because its safety profile. ICERs €8338/QALY, €11,209/QALY €10,133/QALY, respectively, patients. ICER values slightly analysis. PSA suggested consistency results.TAVI would be considered cost-effective frequently cited willingness-to-pay thresholds; further studies could clarify real-life scenarios.