التفاصيل البيبلوغرافية
| العنوان: |
Economic Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Low Surgical Risk: Results from the PARTNER 3 Trial |
| المؤلفون: |
Galper, Benjamin Z., Chinnakondepalli, Khaja M., Wang, Kaijun, Magnuson, Elizabeth A., Lu, Michael, Thourani, Vinod H., Kodali, Susheel, Makkar, Raj, Herrmann, Howard C., Kapadia, Samir, Williams, Mathew, Webb, John, Smith, Craig R., Mack, Michael J., Leon, Martin B., Cohen, David J. |
| المساهمون: |
Edwards Lifesciences |
| المصدر: |
Circulation ; volume 147, issue 21, page 1594-1605 ; ISSN 0009-7322 1524-4539 |
| بيانات النشر: |
Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: |
2023 |
| الوصف: |
Background: In patients with severe symptomatic aortic stenosis at low surgical risk, transfemoral transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 valve has been shown to reduce the composite of death, stroke, or rehospitalization at 2-year follow-up compared with surgical aortic valve replacement (SAVR). Whether TAVR is cost-effective compared with SAVR for low-risk patients remains uncertain. Methods: Between 2016 and 2017, 1000 low-risk patients with aortic stenosis were randomly assigned to TAVR with the SAPIEN 3 valve or SAVR in the PARTNER 3 trial (Placement of Aortic Transcatheter Valves). Of these patients, 929 underwent valve replacement, were enrolled in the United States, and were included in the economic substudy. Procedural costs were estimated using measured resource use. Other costs were determined by linkage with Medicare claims or by regression models when linkage was not feasible. Health utilities were estimated using the EuroQOL 5-item questionnaire. With the use of a Markov model informed by in-trial data, lifetime cost-effectiveness from the perspective of the US health care system was estimated in terms of cost per quality-adjusted life-year gained. Results: Although procedural costs were nearly $19 000 higher with TAVR, total index hospitalization costs were only $591 more with TAVR compared with SAVR. Follow-up costs were lower with TAVR such that TAVR led to 2-year cost savings of $2030/patient compared with SAVR (95% CI, –$6222 to $1816) and a gain of 0.05 quality-adjusted life-years (95% CI, –0.003 to 0.102). In our base-case analysis, TAVR was projected to be an economically dominant strategy with a 95% probability that the incremental cost-effectiveness ratio for TAVR would be <$50 000/quality-adjusted life-year gained (consistent with high economic value from a US health care perspective). These findings were sensitive to differences in long-term survival, however, such that a modest long-term survival advantage with SAVR would render SAVR cost-effective (although ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1161/circulationaha.122.062481 |
| DOI: |
10.1161/CIRCULATIONAHA.122.062481 |
| الإتاحة: |
https://doi.org/10.1161/circulationaha.122.062481Test |
| حقوق: |
https://creativecommons.org/licenses/by-nc-nd/4.0Test/ |
| رقم الانضمام: |
edsbas.D343A70F |
| قاعدة البيانات: |
BASE |
