Asset Details
Do you wish to reserve the book?
The cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at high operative risk
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
The cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at high operative risk
Do you wish to request the book?
The cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at high operative risk
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
The cost-effectiveness of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at high operative risk
2013
Overview
Objective To determine the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared with surgical aortic valve replacement (SAVR) in a high-risk aortic stenosis (AS) population. Design A cost-utility analysis employing the National Institute of Clinical Excellence (NICE) reference case design for technology appraisals. Setting The perspective of the UK National Health Service. Patients Utility data from a UK high-risk AS population. TAVI and SAVR effectiveness was taken from the PARTNER A randomised controlled trial. Main outcome measures Costs modelled over a 10 year horizon using a Markov model. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curve were calculated with reference to the NICE willingness to pay per quality adjusted life year (QALY) gain threshold. Deterministic and probabilistic sensitivity analyses performed. Results Despite greater procedural costs (£16 500 vs £9,256), TAVI was cost-effective compared with SAVR over the 10 year model horizon (costs £52 593 vs £53 943 and QALYs 2.81 vs 2.75), indicating that TAVI dominated SAVR. This appeared to be due to greater postsurgical costs, related to the length and cost of hospital stay. The results appeared robust to a number of deterministic sensitivity and probabilistic analyses. The cost-effectiveness acceptability curve indicated that at the NICE £20 000 willingness to pay threshold per QALY gained, TAVI had a 64.6% likelihood of being cost-effective, compared with 35.4% for SAVR. Conclusions TAVI is likely to be a cost-effective treatment for high-risk patients with AS compared with the reference standard of SAVR. However, uncertainty surrounding the long-term outcomes for TAVI patients remains; this could have a substantive impact on estimates of cost-effectiveness.
Publisher
BMJ Publishing Group Ltd and British Cardiovascular Society,BMJ Publishing Group LTD
Subject
/ Aortic Valve Stenosis - diagnosis
/ Aortic Valve Stenosis - economics
/ Aortic Valve Stenosis - mortality
/ Aortic Valve Stenosis - surgery
/ Aortic Valve Stenosis - therapy
/ Cardiac Catheterization - adverse effects
/ Cardiac Catheterization - economics
/ Cardiac Catheterization - mortality
/ Heart
/ Heart Valve Prosthesis Implantation - adverse effects
/ Heart Valve Prosthesis Implantation - economics
/ Heart Valve Prosthesis Implantation - methods
/ Heart Valve Prosthesis Implantation - mortality
/ Humans
/ Postoperative Complications - economics
/ Postoperative Complications - therapy
/ Randomized Controlled Trials as Topic
/ Studies
/ Tariffs
