Authors' objectives: This systematic review investigated health-economic evaluations on the cost-effectiveness of TAVI for inoperable patients and operable patients with high or moderate surgical risk. For the systematic review, all health-economic analyses published between 2007 and 2017 in English and German were taken into account. The relevance and quality of the evaluations were assessed using the ISPOR-checklist "Assessing the Evidence for Healthcare Decision Makers". To improve the comparability of costs, an inflation and price adjustment of international cost data to an Austrian level (year 2016) was conducted.

Authors' recommendations: The study results showed that: TAVI was cost-effective in inoperable patients compared to Medical Management (1 study), whereas TAVI was cost-effective in only 1 out of 5 studies compared to Standard Management in inoperable patients, and TAVI compared to Surgical Aortic Valve Replacement in patients with high surgical risk resulted in controversial results (4 studies). Sensitivity analyses showed that, in particular, the inclusion of follow-up treatments of serious complications such as stroke or the TAVI procedure costs may influence these results. The transferability of the cost-effectiveness results to Austria can only be recommended with caution: On the one hand, only 8/15 health economic evaluations proved to be sufficiently reliable, on the other hand the results appeared not to be very robust –since the results can be strongly influenced by the inclusion and exclusion of cost parameters– and last because no cost-effectiveness thresholds are used in Austria. Overall, the careful selection of patients based on clinical parameters, as currently managed in Austria, can be considered as good practice.

Project Status: Completed

URL for project: http://hta.lbg.ac.at/page/perkutaner-aortenklappenersatz-teil-i-eine-systematische-uebersichtsarbeit-gesundheitsoekonomischer-evaluierungen/en

Year Published: 2017

URL for published report: http://eprints.hta.lbg.ac.at/1139/1/HTA-Projektbericht_Nr.95a.pdf

URL for additional information: http://eprints.hta.lbg.ac.at/1139/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Austria

Organisation Name: Ludwig Boltzmann Institute for Health Technology Assessment

Contact Address: Ludwig Boltzmann Institute for fuer Health Technology Assessment (LBI-HTA), Garnisongasse 7/rechte Stiege Mezzanin (Top 20), 1090 Vienna, Austria. Tel: +43 1 236 8119 - 0 Fax: +43 1 236 8119 - 99

Contact Name: tarquin.mittermayr@aihta.at

Contact Email: office@aihta.at

Copyright: Ludwig Boltzmann Institut fuer Health Technology Assessment (LBI-HTA)