英国TAVI的成本效益:基于Evolut低风险试验4年数据的长期分析
Daniel J Blackman1, Anne M Ryschon2, Sophie Barnett3
1Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, West Yorkshire, England.
概括
通过导管的大动脉植入 (TAVI) 为低风险患者提供了与手术大动脉置换 (SAVR) 相比更好的生存率和生活质量. 这一更新的英国分析证实了TAVI是一个具有成本效益的干预措施.
科学领域:
- 心血管医学 心血管医学
- 卫生经济学 卫生经济学
背景情况:
- 之前的经过导管的大动脉植入 (TAVI) 与手术大动脉置换 (SAVR) 的成本效益分析已经存在.
- 本文使用了Evolut低风险试验的4年数据进行了针对英国的最新分析.
研究的目的:
- 评估TAVI与SAVR在英国低手术风险患者的终身成本效益.
- 将四年后续数据纳入经济模型.
主要方法:
- 一个决策分析马尔科夫模型被用于终身结果和成本预测.
- 模型参数由4年试验数据,英格兰NHS成本和3.5%的折扣率提供信息.
- 根据每QALY值的20,000英到30,000英的价格,评估了成本效益.
主要成果:
- 塔维显示每QALY获得的增量成本效益比率 (ICER) 为17,883英,表明成本效益.
- 模拟显示,在分别达到20,000英和30,000英的门时,TAVI在57.5%和85.3%的案件中具有成本效益.
- 使用四年数据显著提高了TAVI的预计寿命成本效益.
结论:
- 塔维提供了有意义的长期患者益处,包括改善生存率和质量调整寿命年 (QALYs).
- 这些发现支持TAVI作为英国低手术风险患者的经济有效的治疗选择.
- 更新的数据强化了TAVI对SAVR的经济论证.
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