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Economic Evaluation of Transcatheter Aortic Valve Replacement Compared to Surgical Aortic Valve Replacement in

Weicong Zhang1, Yake Lou2, Yujiang Liu1

  • 1Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Frontiers in Cardiovascular Medicine
|June 20, 2022
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) is not cost-effective in China compared to surgical aortic valve replacement (SAVR). TAVR could become cost-effective if its price is reduced by approximately 65%.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Medical Technology Assessment

Background:

  • Aortic stenosis (AS) is a severe condition leading to heart failure and sudden death.
  • Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are recommended for intermediate-risk patients.
  • The cost-effectiveness of TAVR versus SAVR in China remains unexamined.

Purpose of the Study:

  • To evaluate the cost-effectiveness of TAVR compared to SAVR in China.
  • To determine the economic viability of TAVR for treating aortic stenosis in the Chinese healthcare system.

Main Methods:

  • A combined decision tree and Markov model simulated a 5-year period.
  • The primary metric was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY).
  • Sensitivity analyses (one-way and probabilistic) assessed model robustness.

Main Results:

  • TAVR incurred higher costs ($54,573) and yielded slightly better effectiveness (2.826 QALY) than SAVR ($35,002; 2.712 QALY).
  • The ICER for TAVR was $170,056/QALY, significantly exceeding China's per capita GDP.
  • Device cost was a key factor; TAVR becomes cost-effective if its price drops to $29,766.

Conclusions:

  • Transcatheter aortic valve replacement is currently not cost-effective in China.
  • A substantial cost reduction (approx. 65%) is necessary for TAVR to achieve cost-effectiveness in China.
Abstract

Keywords:
SAVRTAVRaortic stenosiscost-effectivenesseconomic evaluation

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