Key result
Bovine pericardial valves approach budget neutrality vs mechanical valves over ~5 years via downstream savings.
Why the study?
To analyze the budget impact of using a bovine pericardial aortic bioprosthesis versus a mechanical valve in aortic stenosis patients in Romania.
Does a bovine pericardial aortic bioprosthesis reduce healthcare costs compared to a mechanical valve in adult patients with aortic stenosis?
Does a bovine pericardial aortic bioprosthesis reduce healthcare costs compared to a mechanical valve in adult patients with aortic stenosis?
Using a bovine pericardial aortic bioprosthesis instead of a mechanical valve for aortic stenosis in Romania is a budget-neutral strategy over 5 years due to offset costs from reduced anticoagulation and complications.
Answers are grounded in this paper and cite their sources.
May support bioprosthesis selection for cost neutrality in aortic stenosis; leaves open randomized confirmation beyond this cohort.
AIMS: An analysis of the budget impact of using a bovine pericardial aortic bioprosthesis (BPAB) or a mechanical valve (MV) in aortic stenosis (AS) patients in Romania. MATERIALS AND METHODS: A decision-tree with a partitioned survival model was used to predict the financial outcomes of using either a BPAB (the Carpentier-Edwards Perimount Magna Ease Valve) or MV in aortic valve replacement (AVR) procedure over a 5-year period. The budget impact of various resource consumption including disabling strokes, reoperations, minor thromboembolic events, major bleeding, endocarditis, anticoagulation treatment and monitoring, and echocardiogram assessments were compared for both types of valves. One-way sensitivity analyses (OWSA) were conducted on the input costs and probabilities. RESULTS: The use of BPAB compared to MV approaches budget neutrality due to incremental savings year-on-year. The initial surgical procedure and reoperation costs for BPAB are offset by savings in acenocoumarol use, disabling strokes, major bleeding, minor thromboembolic events, and anticoagulation complications. The cost of the initial procedure per patient is 460 euros higher for a BPAB due to the higher valve acquisition cost, although this is partially offset by a shorter hospital stay. The OWSA shows that the total procedure costs, including the hospital stay, are the primary cost drivers in the model. LIMITATIONS: Results are limited by cost data aggregation in the DRG system, exclusion of costs for consumables and capital equipment use, possible underestimation of outpatient complication costs, age-related variations of event rates, and valve durability. CONCLUSIONS: Adopting BPAB as a treatment option for AS patients in Romania can lead to cost savings and long-term economic benefits. By mitigating procedure costs and increasing anticoagulation treatment costs, BPAB offers a budget-neutral option that can help healthcare providers, policymakers, and patients alike manage the growing burden of AS in Romania.
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Carapinha et al. (2023) studied Aortic stenosis. Bovine pericardial aortic bioprosthesis (BPAB) vs. Mechanical valve (MV) was evaluated on Budget impact over a 5-year period. A bovine pericardial aortic bioprosthesis approaches budget neutrality over 5 years compared to a mechanical valve, as the 460 euro higher initial procedure cost is offset by downstream savings.
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