Cost-Effectiveness of Transcatheter Aortic Valve Intervention (TAVI) Compared to Surgical Aortic Valve Replacement (SAVR) in Low- to Intermediate-Surgical-Risk Patients

Abstract

Introduction: Transcatheter aortic valve intervention (TAVI) is known to be non-inferior to surgical aortic valve replacement (SAVR) in low-intermediate surgical risk patients. This present systematic review was conducted to analyse the cost-effectiveness of TAVI in this patient population.

Methods: Four electronic databases from January 2010 to November 2019 were used to identify relevant cost-effectiveness studies of TAVI versus SAVR in low-intermediate risk patients. The primary endpoints were the incremental cost-effectiveness ratio (ICER) and the probability of cost effectiveness. The eligible studies for the present systematic review included those in which the cost-effectiveness data were measured or projected for TAVI and SAVR.

Results: Eight studies were included in this review, where six studies involved intermediate risk patients and two studies with low risk patients. The reported ICER for TAVI compared to SAVR in low-intermediate risk patients were below the ICER threshold of acceptability in all studies. The probability of TAVI being cost-effective compared to SAVR ranged from 78%-97%.

Conclusions: TAVI is likely to be a cost-effective alternative to SAVR in low-intermediate risk patients. More studies on low risk patients is needed.

Keywords: Aortic stenosis.; Cost-effectiveness.; Surgical aortic valve replacement.; Transcatheter aortic valve intervention; Transcatheter aortic valve replacement..