Cost-effectiveness of transcatheter aortic valve implantation (TAVI) for aortic stenosis in patients who are high risk or contraindicated for surgery: a model-based economic evaluation
Orlando R, Pennant M, Rooney S, Khogali S, Bayliss S, Hassan A, Moore D, Barton P
Record ID 32011000635
English
Authors' objectives:
The objective of this work was to determine the cost-effectiveness of TAVI being available compared with not being available for patients who are high risk or in whom SAVR is contraindicated. The work aimed to
conduct a literature review of cost-effectiveness studies and to build a model to analyse the
cost-effectiveness of the use of TAVI in practice.
Authors' recommendations:
The results given here for TAVI compared with medical management in patients unsuitable for surgery
are reasonably robust and suggest that TAVI is likely to be cost-effective in these patients. On the other hand, for patients who could have surgery as an alternative, the model results suggest that TAVI could be both more costly and less effective than SAVR. However, these results are not based on randomised data and could easily be upset by the results of trials reporting after this work was carried out.
The overall results suggest that the total effect of introducing TAVI falls within conventional standards of
cost-effectiveness. It should be stressed that this depends on the assumption that a very substantial majority of TAVI patients will be those who are unsuitable for surgery. From a decision-theoretic point of view, the overall results should not be used to guide any decision, but the decision to allow TAVI for different patient groups should be taken separately for each group based on the results for that patient group alone. However, in practice a decision to allow TAVI for patients deemed unsuitable for surgery is likely to lead to TAVI being offered to some higher-risk patients who would have received surgery in the absence of TAVI. It is helpful to quantify the importance of this possibility.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://www.hta.ac.uk/2457
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Aortic Valve Stenosis
- Cost-Benefit Analysis
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
<p>2013 Queen's Printer and Controller of HMSO</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.