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- W2152497461 abstract "The primary analysis of this study was to estimate the cost-effectiveness of TAVI compared to standard management (SM) in inoperable patients with severe, symptomatic aortic valve stenosis (SSAVS). The secondary analysis was to preliminarily explore both the cost-effectiveness and value of information of TAVI compared to surgical aortic valve replacement (SAVR) in operable patients at high surgical risk with SSAVS. A combined decision tree and Markov model was developed to compare the costs, life-years (LYs) and quality-adjusted life-years (QALYs) of TAVI (transfemoral (TF) and transapical (TA) approaches) to SM and SAVR over a 5-year time horizon. This evaluation was conducted from a third party payer's perspective. In the primary analysis, comparing TF and SM resulted in an incremental cost-effectiveness ratio (ICER) of $126,874/LY and $222,378/QALY. Comparing TA and SM resulted in an ICER of $262,672/LY and $1,454,241/QALY. In the secondary analysis, TF and SAVR were compared, resulting in an ICER of $39,676/LY and $81,758/QALY. Comparing TA and SAVR resulted in an ICER of $183,454/LY. TA was dominated by SAVR when comparing QALYs. The total expected value of perfect information (EVPI) was at a maximum with a value of $6,928 at a WTP threshold of $80,000/QALY. The expected value of partial perfect information (EVPPI) was highest for the 30-day clinical event rates when compared to the EVPPI values for the 1-year, 2-year and >3-year clinical event rates. This economic evaluation suggested that TAVI might not be a cost-effective option for inoperable patients in comparison to SM. The secondary analysis suggested that TAVI might be a cost effective option for operable patients compared to SAVR. To reduce the uncertainty in our estimate it might be worthwhile to obtain empirical evidence related to clinical event rates occurring 30-days post operation." @default.
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- W2152497461 date "2011-05-01" @default.
- W2152497461 modified "2023-10-07" @default.
- W2152497461 title "PMD25 THE COST-UTILITY AND VALUE OF INFORMATION OF TRANSCATHETER AORTIC VALVE IMPLANTATION COMPARED TO STANDARD MANAGEMENT AND SURGICAL AORTIC VALVE REPLACEMENT IN PATIENTS WITH SEVERE SYMPTOMATIC AORTIC VALVE STENOSIS" @default.
- W2152497461 doi "https://doi.org/10.1016/j.jval.2011.02.465" @default.
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