Cost-Effectiveness of Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Stenosis at Intermediate Risk
Key result
In intermediate-risk severe aortic stenosis, TAVR was economically dominant compared with SAVR, lowering lifetime costs by $8,000-$10,000 and increasing quality-adjusted survival by 0.15-0.27 years.
Why the study?
In patients with severe aortic stenosis at intermediate surgical risk, TAVR and SAVR result in similar 2-year death or stroke rates, but whether TAVR is cost-effective compared with SAVR remained uncertain.
Does TAVR improve cost-effectiveness compared to SAVR in patients with severe aortic stenosis at intermediate surgical risk?
Study Design
Type
RCT (n=3,110)
Randomization
randomized
Structured PICO
Does TAVR improve cost-effectiveness compared to SAVR in patients with severe aortic stenosis at intermediate surgical risk?
P
Population
3,110 patients with severe aortic stenosis at intermediate surgical risk, evaluated for lifetime cost-effectiveness of TAVR versus SAVR.
I
Intervention
Transcatheter aortic valve replacement (TAVR) using SAPIEN XT or SAPIEN 3 valve
C
Comparator
Surgical aortic valve replacement (SAVR)
O
Outcome
Lifetime cost-effectiveness (cost per quality-adjusted life-year gained) from the perspective of the US healthcare system
TAVR is projected to be economically dominant compared to SAVR in intermediate-risk patients with severe aortic stenosis, providing greater quality-adjusted life expectancy at lower long-term costs.
Limitations
- Findings depend on long-term data demonstrating comparable late mortality with TAVR and SAVR
Authors
Discussion
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Implication
Supports TAVR economic dominance in intermediate-risk severe AS; leaves open need for randomized confirmation.
Cite This Study
Baron et al. (2019) conducted an RCT in Severe aortic stenosis at intermediate surgical risk (n=3,110). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated on Lifetime cost-effectiveness (cost per quality-adjusted life-year gained). In intermediate-risk severe aortic stenosis, TAVR was economically dominant compared with SAVR, lowering lifetime costs by $8,000-$10,000 and increasing quality-adjusted survival by 0.15-0.27 years.