Table 3.
Projected Lifetime Costs, QALYs, and Cost-Effectiveness Ratios
| Lifetime Costs ($) | LYs or QALYs | ICER ($/QALY) | Probability <$50,000 per QALY | Probability <$150,000 per QALY | |||||
|---|---|---|---|---|---|---|---|---|---|
| TAVR | SAVR | Δ | TAVR | SAVR | Δ | ||||
| Base Case | 207,478 | 189,629 | 17,849 | 4.149 | 3.825 | 0.324 | 55,090 | 40.3% | 90.0% |
| Subgroup Analyses | |||||||||
| IF Access (n = 627) | 202,799 | 191,479 | 11,320 | 4.101 | 3.887 | 0.214 | 52,897 | 42.6% | 75.2% |
| Non-IF Access (n = 120) | 229,487 | 181,784 | 47,703 | 4.321 | 3.561 | 0.760 | 62,767 | 27.6% | 83.1% |
| STS PROM ≥ 7 (n = 376) | 190,957 | 183,749 | 7208 | 3.449 | 3.417 | 0.032 | 225,250 | 25.4% | 44.5% |
| STS PROM <7 (n = 371) | 222,812 | 196,842 | 25,970 | 4.808 | 4.285 | 0.523 | 49,656 | 46.6% | 92.8% |
| Male (n = 394) | 196,144 | 186,397 | 9,747 | 3.911 | 3.814 | 0.098 | 99,459 | 26.7% | 49.7% |
| Female (n = 353) | 219,025 | 194,354 | 24,671 | 4.377 | 3.874 | 0.502 | 49,145 | 50.0% | 94.0% |
| Age ≥ 85 yrs (n = 377) | 176,420 | 165,977 | 10,443 | 3.060 | 2.848 | 0.211 | 49,493 | 50.1% | 80.2% |
| Age <85 yrs (n = 370) | 237,939 | 215,022 | 22,917 | 5.223 | 4.852 | 0.370 | 61,938 | 31.8% | 81.6% |
| Sensitivity/Scenario Analyses | |||||||||
| Effectiveness = LYs | 207,478 | 189,629 | 17,849 | 5.469 | 5.055 | 0.414 | 43,114 | 63.9% | 92.1% |
| Discount rate 0% | 230,921 | 210,433 | 20,488 | 4.878 | 4.478 | 0.400 | 51,220 | 47.0% | 90.3% |
| Discount rate 5% | 195,540 | 178,922 | 16,618 | 3.776 | 3.488 | 0.288 | 57,701 | 35.8% | 90.0% |
| Long-term hazard ratio = 0.86 | 215,243 | 189,629 | 25,615 | 4.390 | 3.825 | 0.566 | 45,256 | 63.7% | 99.3% |
| No difference in 1 month QOL | 207,478 | 189,629 | 17,849 | 4.138 | 3.832 | 0.306 | 58,330 | 33.3% | 88.6% |
| No costs in added LYs | 116,717 | 106,113 | 10,604 | 4.149 | 3.825 | 0.324 | 32,728 | 70.8% | 91.3% |
ICER = incremental cost-effectiveness ratio; IF = iliofemoral; LY = life-year; QALY = quality-adjusted life-year; QOL = quality of life; STS PROM = Society of Thoracic Surgeons predicted risk of mortality. Other abbreviations as in Table 1.