Key result
TAVI shows inconsistent cost-effectiveness compared to surgery or medical therapy across economic evaluations.
Why the study?
To update the existing body of evidence regarding the cost-effectiveness of transcatheter aortic valve implantation across all risk categories and assess its methodological quality.
Is transcatheter aortic valve implantation cost-effective compared to medical management or surgical aortic valve replacement across various patient risk categories?
Systematic Review (n=33)
Is transcatheter aortic valve implantation cost-effective compared to medical management or surgical aortic valve replacement across various patient risk categories?
The cost-effectiveness of TAVI is highly sensitive to regional inputs, specific patient cohorts, and model assumptions, yielding inconclusive generalized economic results.
TAVI cost-effectiveness cannot be assumed across settings; leaves open the need for standardized, context-specific economic models.
Objective: The scope of this systematic review is to update the existing body of evidence regarding the cost-effectiveness of transcatheter aortic valve implantation, stratified across all risk categories, and to assess their methodological quality. Methods: A systematic review was performed including published cost-effectiveness analyses of heart valve implantations. The quality was assessed with the Quality of Health Economics Tool. Results: We identified 33 economic evaluations of transcatheter aortic heart valve implantations. Results were not consistent, ranging from dominant to dominating. Moreover, the models were sensitive to an array of variables. The methodological quality of the studies was good. Conclusion: This systematic review led to inconclusive and inconsistent results pertinent to the economic profile of TAVI technology. It also highlighted areas which merit further research regarding the pillars of cost-effectiveness analysis such as modeling, the extrapolation of available data and the uncertainty of the evidence. A thorough assessment of the patient should proceed any decision-making.
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Panagiotis Petrou (2023) conducted a systematic review in Aortic stenosis across all risk categories (inoperable, high, intermediate, low surgical risk) (n=33). Transcatheter aortic valve implantation (TAVI) vs. Medical management or surgical aortic valve replacement (SAVR) was evaluated on Cost-effectiveness (ICER, ICUR). This systematic review of 33 economic evaluations yielded inconclusive and inconsistent results regarding the cost-effectiveness of TAVI, with findings ranging from TAVI being dominant to being dominated by alternatives depending on variables and assumptions.
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