Table 2.

Costs and utilities

			Distribution	Source
Intervention costs
SAVR	25,474		Multivariate normal4	[4]*
TAVI	33,178		Multivariate normal4	[4]*
Event treatment costs
Stroke	3054		Multivariate normal4	[4]*
Myocardial infarction	5157		Multivariate normal4	[4]*
Vascular complications	5112		Uniform (∓ 20%)	[48]
Reexploration for bleeding	5048		Uniform (∓ 20%)	[48]
Bleeding	1617		Uniform (∓ 20%)	[48]
Atrial fibrillation (without PI)	1225		Multivariate normal4	[4]*
Pacemaker implantation (PI)	11,738		Multivariate normal4	[4]*
Acute kidney injury/renal failure	9650		Multivariate normal4	[4]*
Prosthetic valve dysfunction	1478		Uniform (∓ 20%)	[49–54]
Prosthetic valve thrombosis	5824		Uniform (∓ 20%)	[53–55]
Prosthetic valve endocarditis	8923		Multivariate normal4	[4]*
Re-intervention SAVR	25,936		Multivariate normal4	[4]*
Re-intervention TAVI	33,178		Multivariate normal4	[4]*
Other healthcare cost1
Post-intervention year 1	18,479		Multivariate normal4	[4]*
Post-intervention year 2	10,607			[4]*
Post-intervention year 3	10,832			[4]*
Productivity costs of unpaid work3	Costs per month
SAVR	44		Multivariate normal4	[23]
TAVI	50		Multivariate normal4	[23]
Informal care costs3	Costs per month
SAVR	164		Multivariate normal4	[23]
TAVI	388		Multivariate normal4	[23]
Utilities at start of the simulation
SAVR	0.837		Multivariate normal4	[23]
TAVI	0.718		Multivariate normal4	[23]
Utilities after events	Utility multiplier	Duration
Stroke	0.841	Lifetime	Uniform5	[56, 57]
Myocardial infarction	0.914	1 year	Uniform5	[58, 59]
Vascular complications	0.981	1 week	Uniform5	[60]
Bleeding	0.965	1 year	Uniform5	[61]
Atrial fibrillation (without PI)	0.955	1 year	Uniform5	[62]
Pacemaker implantation (PI)	0.804	1 month	Uniform5	[63]
Acute kidney injury/renal failure	0.804	1 year	Uniform5	[64]
Re-intervention	0.946	SAVR/TAVI: 4/1 month(s)	Uniform5	[65]/[8]
Conservative treatment of:
Prosthetic valve dysfunction	0.8862	Lifetime	Uniform5	[50, 66]
Prosthetic valve thrombosis	0.9682	10 days	Uniform5	[55, 67]
Prosthetic valve endocarditis	0.9682	6 weeks	Uniform5	[67, 68]

*Mean in the Vektis database adjusted to 2016€. Costs in the model dependent on patient and intervention characteristics using (M)GLM [4]

¹Mean total healthcare costs per year including costs of treatment of events and death (costs types are estimated separately in the model), but excluding intervention costs. Costs are based on data of SAVR patients, but it is assumed they are also applicable to TAVI patients

²Conservative treatment, no re-intervention

³Mean across all patients, including patients without unpaid work or informal care

⁴Multivariate normal distribution: coefficients of the regression model are randomly drawn from a multivariate normal distribution based on coefficients and variance–covariance matrix

⁵50% deviation of 1-utility multiplier to prevent the utility multiplier from exceeding 1