Cost-effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results of the PARTNER (Placement of Aortic Transcatheter Valves) trial (Cohort A).
Cost-effectiveness of transcatheter aortic valve replacement compared with surgical aortic valve replacement in high-risk patients with severe aortic stenosis: results of the PARTNER (Placement of Aortic Transcatheter Valves) trial (Cohort A).
- 2012
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
BACKGROUND: TAVR is an alternative to AVR for patients with severe aortic stenosis and high surgical risk. CONCLUSIONS: In the PARTNER trial, TAVR was an economically attractive strategy compared with AVR for patients suitable for TF access. Future studies are necessary to determine whether improved experience and outcomes with TA-TAVR can improve its cost-effectiveness relative to AVR. Copyright 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. METHODS: We performed a formal economic analysis based on cost, quality of life, and survival data collected in the PARTNER A (Placement of Aortic Transcatheter Valves) trial in which patients with severe aortic stenosis and high surgical risk were randomized to TAVR or AVR. Cumulative 12-month costs (assessed from a U.S. societal perspective) and quality-adjusted life-years (QALYs) were compared separately for the transfemoral (TF) and transapical (TA) cohorts. OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (AVR) for patients with severe aortic stenosis and high surgical risk. RESULTS: Although 12-month costs and QALYs were similar for TAVR and AVR in the overall population, there were important differences when results were stratified by access site. In the TF cohort, total 12-month costs were slightly lower with TAVR and QALYs were slightly higher such that TF-TAVR was economically dominant compared with AVR in the base case and economically attractive (incremental cost-effectiveness ratio <
English
0735-1097
*Aortic Valve Stenosis/su [Surgery]
*Cardiac Catheterization/ec [Economics]
*Heart Valve Prosthesis Implantation/ec [Economics]
*Quality-Adjusted Life Years
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve Stenosis/ec [Economics]
Cost-Benefit Analysis
Female
Heart Valve Prosthesis Implantation/mt [Methods]
Humans
Male
Risk Factors
Severity of Illness Index
Treatment Outcome
United States
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
BACKGROUND: TAVR is an alternative to AVR for patients with severe aortic stenosis and high surgical risk. CONCLUSIONS: In the PARTNER trial, TAVR was an economically attractive strategy compared with AVR for patients suitable for TF access. Future studies are necessary to determine whether improved experience and outcomes with TA-TAVR can improve its cost-effectiveness relative to AVR. Copyright 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. METHODS: We performed a formal economic analysis based on cost, quality of life, and survival data collected in the PARTNER A (Placement of Aortic Transcatheter Valves) trial in which patients with severe aortic stenosis and high surgical risk were randomized to TAVR or AVR. Cumulative 12-month costs (assessed from a U.S. societal perspective) and quality-adjusted life-years (QALYs) were compared separately for the transfemoral (TF) and transapical (TA) cohorts. OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (AVR) for patients with severe aortic stenosis and high surgical risk. RESULTS: Although 12-month costs and QALYs were similar for TAVR and AVR in the overall population, there were important differences when results were stratified by access site. In the TF cohort, total 12-month costs were slightly lower with TAVR and QALYs were slightly higher such that TF-TAVR was economically dominant compared with AVR in the base case and economically attractive (incremental cost-effectiveness ratio <
English
0735-1097
*Aortic Valve Stenosis/su [Surgery]
*Cardiac Catheterization/ec [Economics]
*Heart Valve Prosthesis Implantation/ec [Economics]
*Quality-Adjusted Life Years
Aged, 80 and over
Aortic Valve Stenosis/di [Diagnosis]
Aortic Valve Stenosis/ec [Economics]
Cost-Benefit Analysis
Female
Heart Valve Prosthesis Implantation/mt [Methods]
Humans
Male
Risk Factors
Severity of Illness Index
Treatment Outcome
United States
MedStar Heart & Vascular Institute
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial