Cost-Effectiveness of Transcatheter Aortic Valve Replacement Compared With Standard Care Among Inoperable Patients With Severe Aortic Stenosis

• DOI: 10.1161/circulationaha.111.054072
• Publication Date: 2012-02-04T04:45:19Z
• Authors: Matthew R. Reynolds; Elizabeth A. Magn...; Kaijun Wang; Yang Lei; Katherine Vilain; Joshua Walczak; Susheel K. Kodali; John M. Lasala; William W. O'Neill; Charles J. Davidson; Craig R. Smith; Martin B. Leon; David J. Cohen
• Keywords: Standard of care; Valve replacement

Background— In patients with severe aortic stenosis who cannot have surgery, transcatheter valve replacement (TAVR) has been shown to improve survival and quality of life compared standard therapy, but the costs cost-effectiveness this strategy are not yet known. Methods Results— The PARTNER trial randomized symptomatic, were candidates for surgery TAVR (n=179) or therapy (n=179). Empirical data regarding survival, life, medical resource use, hospital collected during used project expectancy, quality-adjusted lifetime care estimate incremental from a US perspective. For treated TAVR, mean initial procedure hospitalization $42 806 $78 542, respectively. Follow-up through 12 months lower ($29 289 versus $53 621) because reduced rates, cumulative 1-year remained higher ($106 076 621). We projected that over patient's lifetime, would increase discounted expectancy by 1.6 years (1.3 life-years) at an cost $79 837. ratio was thus estimated $50 200 per year gained $61 889 life-year gained. These results stable across broad range uncertainty sensitivity analyses. Conclusions— increases well within accepted values commonly cardiovascular technologies. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00530894.