Table 3.
Economic evaluations in intermediate-risk patients.
| Author publication year) | Country/Perspective/ Funding | Agents | Time Horizon | Model | Treatment Incremental costs | Currency | LYG gained | QALY’s gained | Cost-effectiveness (CE) LYG | WTP | Cost-utility (CU) QALY | Other comments |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lorenzoni et al 2021[24] | Italy/ Italian health system perspective/ Industry Funded | TAVI SAPIEN 3 vs SAVR | 15-year time horizon | Markov Model with 8 states | Incremental costs: €3,593 TAVI: €36,623 SAVR: €33,030 |
EUR | Incremental gain:0.44 LYG TAVI: 6.08 LYG SAVR :5.64 LUG |
Incremental gain: 0.43 QALY TAVI: 4.21 QALY SAVR: 3.78 QALY |
€8,035 per LYG | €30,000 | €8,338 per QALY gained | Model was sensitive to mortality, to major incidence of stroke and repeated hospitalizations for AS |
| Pinar et 2021[21] | Spain/ National Health Care System of Spain perspective/ Industry Funded | TAVI SAPIEN 3 SAVR | 15-year time horizon | Markov mathematical model with 9 monthly exclusive states with | Incremental costs:€3,537 TAVI: €50,950 eur SAVR :€47,413 |
EUR | Incremental gain:0.44 LYG TAVI: 6.08 LYG SAVR: 5.64 LYG |
Incremental gain:0.44 QALY TAVI: 4.59 QALY SAVR: 4.15 QALY |
€7,910 per LYG | €30,000 | €8,119 per QALY gained | |
| Zhou et al, 2019 [48] | Australia/Health Payer perspective/ Funded | TAVI vs SAVR | 10-year time horizon | Markov Model | Incremental costs -$9,629 TAVI: $50,515 SAVR: $60,144 |
AUD | Incremental gain: 0.33 LYG TAVI:5.43 LYG SAVR:5.10 LYG |
Incremental gain: 0.31 QALY TAVI:4.13 QALY SAVR:3,82 QALY |
TAVI IS DOMINANT | $50,000 | TAVI IS DOMINANT | Results were sensitive to SAVR length of stay and cost of TAVI |
| Baron et al USA,2019 [46] | USA/ US Healthcare system perspective/ Industry Funded | TAVI SAPIEN XT/ SAPIEN 3 vs SAVR |
Lifetime | Markov Model | Incremental Costs: SAPIEN XT vs SAVR:-US$7949 SAPIEN 3 valve vs SAVR:-US$9692 |
USD | XT TAVR 7.80 (6.49 discounted) LYG SAVR 7.64(6.35 discounted) LYG S3-TAVR 7.95 (6.63 discounted) LYG SAVR 7.61 (6.34 discounted)LYG |
XT TAVR:5.16 QALY SAVR: 5.01 QALY SAPIEN 3 5.29 QALY SAVR: 5.01 |
$100,000 | BOTH TAVI DOMINATED SAVR | Model was sensitive to follow-up costs | |
| Tarride et al,2019 [44] | Canada/Canadian third-party payer perspective/ Industry Funded | TAVI vs SAVR | 15-year time horizon | Markov Model | Incremental costs: $15,784 TAVI:$59,395 SAVR:$43,611 |
USD | N/R | Incremental gain:0.48 TAVI: 5.10 SAVR:4.62 |
$50,000 | $28,154 per QALY gained | Results were sensitive to the time-horizon of the study | |
| Goodall et al 2019 [49] | France/French all payer perspective /Industry Funded | TAVI SAPIEN 3 vs SAVR | 15-year time horizon | Incremental costs: -€439 for TAVI TAVI:€34,157 SAVR:€34,596 |
EUR | Incremental Gain: 0.42 LYG TAVI:5.87 SAVR:5.44 |
Incremental Gain:O.41 QALY TAVI:4.06 SAVR:3.65 |
TAVI dominates SAVR | TAVI dominates SAVR | Results were sensitive to TAVI and SAVR admission costs | ||
| Tam et al 2018 [52] | Canada/Canadian third-party payer’s perspective/ Industry Funded | TAVI SAPIEN XT vs SAVR | Lifetime | Markov Model | Incremental costs: $10,547 TAVI:$46,904 SAVR: $36,356 |
CAD | N/R | Incremental gain: 0.23 QALY TAVI:5.63 SAVR:5.40 |
$50,000 | $46,083 per QALY gained | Resutls were sensitive to the acquisition cost and ICU length of stay | |
| Kodera et al, 2018 [9] | Japan/Japanese public Healthcare payer/ No funding was received |
TF TAVI vs SAVR | 10 -year time horizon | Markov Model with Monte Carlo Simulations | Incremental costs: ¥1,723,516 ¥8,039,694 ¥6,316178 |
JPY | N/R | Incremental gain:0.22 QALY TAVI: 4.81 QALY SAVR:4.59 QALY |
N/R | ¥5,000,000 | ¥7,523,821 per QALY gained | Model was sensitive to long-term mortality of TAVI |
| Ribera et al 2015 [53] | Spain/ Spanish health services/Funded from Fondo de Investigación Sanitaria, Instituto Carlos III, and the Spanish Ministry of Economy and Competitiveness |
TAVI Medtronic Corevalve(MC) vs Edward SAPIEN (ES) c vs SAVR | One-year time horizon | Costs were reported as mean (SD) and median and were compared using t-tests. Survival was assessed through Kaplan- Meier survival curves | ES-TAVI: €32,087 MC-TAVI: €32,111 SAVR:€ 23,288 |
EUR | N/R | ES-TAVI: 0.680 QALY MC-TAVI: 0.633 QALY SAVR: 0.644 QALY |
N/R | €30,000 | ES-TAVI vs SAVR: €148, 535 perQALY gained SAVR DOMINATED MC-TAVI |
The results were sensitive to patients with high preoperative serum creatinine, cost of TAVR devices and hospitalization costs |
Abbreviations: TF, transfemoral; TA, transapical; SAVR, Surgical aortic valve replacement