Transcatheter aortic valve implantation versus surgical aortic valve replacement in severe aortic stenosis patients at low surgical mortality risk: a cost-effectiveness analysis in Belgium.

peer reviewed ; BACKGROUND: Transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 device has recently shown significant clinical benefits, compared to surgical aortic valve replacement (SAVR), in patients at low risk for surgical mortality (PARTNER 3 trial, NCT02675114). Currently in Belgium, TAVI use is restricted to high-risk or inoperable patients with severe symptomatic aortic stenosis (sSAS). This cost-utility analysis aimed to assess whether TAVI with SAPIEN 3 could lead to potential cost-savings compared with SAVR, in the low-risk sSAS population in Belgium. METHODS: A previo... Mehr ...

Verfasser: Dubois, Christophe
Adriaenssens, Tom
Annemans, Lieven
Bosmans, Johan
Callebaut, Britt
Candolfi, Pascal
Cornelis, Kristoff
Delbaere, Alexis
Green, Michelle
Kefer, Joelle
Lancellotti, Patrizio
Rosseel, Michael
Shore, Judith
Van Der Heyden, Jan
Vermeersch, Sebastian
Wyffels, Eric
Dokumenttyp: journal article
Erscheinungsdatum: 2024
Verlag/Hrsg.: Taylor & Francis
Schlagwörter: Humans / Aortic Valve/surgery / Transcatheter Aortic Valve Replacement / Cost-Effectiveness Analysis / Belgium/epidemiology / Quality of Life / Constriction / Pathologic / Aortic Valve Stenosis/surgery / SAVR / TAVI / aortic stenosis / cost-effectiveness / low risk / Human health sciences / Cardiovascular & respiratory systems / Sciences de la santé humaine / Systèmes cardiovasculaire & respiratoire
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-26593376
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://orbi.uliege.be/handle/2268/314105

peer reviewed ; BACKGROUND: Transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 device has recently shown significant clinical benefits, compared to surgical aortic valve replacement (SAVR), in patients at low risk for surgical mortality (PARTNER 3 trial, NCT02675114). Currently in Belgium, TAVI use is restricted to high-risk or inoperable patients with severe symptomatic aortic stenosis (sSAS). This cost-utility analysis aimed to assess whether TAVI with SAPIEN 3 could lead to potential cost-savings compared with SAVR, in the low-risk sSAS population in Belgium. METHODS: A previously published, two-stage, Markov-based cost-utility model was used. Clinical outcomes were captured using data from PARTNER 3 and the model was adapted for the Belgian context using cost data from the perspective of the Belgian National Healthcare System, indexed to 2022. A lifetime horizon was chosen. The model outputs included changes in direct healthcare costs, survival and health-related quality of life using TAVI versus SAVR. RESULTS: TAVI with SAPIEN 3 provides meaningful clinical and cost benefits over SAVR, in terms of an increase in quality-adjusted life years (QALYs) of 0.94 and cost-saving of €3 013 per patient. While initial procedure costs were higher for TAVI compared with SAVR, costs related to rehabilitation, disabling stroke, treated atrial fibrillation, and rehospitalization were lower. The cost-effectiveness of TAVI over SAVR remained robust in sensitivity analyses. CONCLUSION: TAVI with SAPIEN 3 may offer a meaningful alternative intervention to SAVR in Belgian low-risk patients with sSAS, showing both clinical benefits and cost savings associated with post-procedure patient management.