Coste-efectividad del implante percutáneo de válvula aórtica con SAPIEN 3 en pacientes con bajo riesgo de mortalidad quirúrgica en España

  1. José Manuel Vázquez Rodríguez 1
  2. Eduardo Pinar Bermúdez 2
  3. José Luis Zamorano Gómez 3
  4. José Moreu 4
  5. José Francisco Díaz Fernández 5
  6. Bruno García del Blanco 6
  7. Archita Sarmah 7
  8. Pascal Candolfi 7
  9. Judith Shore 8
  10. Michelle Green 8
  1. 1 Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidad de A Coruña, A Coruña, España
  2. 2 Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
  3. 3 Departamento de Cardiología, Hospital Ramón y Cajal, Madrid, España
  4. 4 Servicio de Cardiología, Hospital Universitario de Toledo, Toledo, España
  5. 5 Unidad de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen del Rocío, Seville, España
  6. 6 Servicio de Cardiología, Hospital Universitari Vall d’Hebron, Barcelona, España
  7. 7 Edwards Lifesciences, Nyon, Suiza
  8. 8 York Health Economics Consortium, University of York, York, Reino Unido
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Journal:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Year of publication: 2023

Volume: 5

Issue: 1

Pages: 38-45

Type: Article

DOI: 10.24875/RECIC.M22000337 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: REC: Interventional Cardiology

Sustainable development goals

Abstract

Introduction and objectives: Transcatheter aortic valve implantation (TAVI) was first introduced in 2007 as an alternative to open heart surgery to treat patients with severe symptomatic aortic stenosis (sSAS) with various indication expansions since that date. Recently, the PARTNER 3 study (Placement of aortic transcatheter valve) demonstrated clinical benefits with TAVI with the SAPIEN 3 valve vs surgical aortic valve replacement (SAVR) in selected low surgical mortality risk patients. We reviewed data from the PARTNER 3 and economic data from Spain to assess the cost-effectiveness ratio of TAVI vs SAVR in patients with sSAS and low surgical mortality risk. Methods: A 2-stage model was used to estimate direct healthcare costs and health-related quality of life data regarding TAVI with the SAPIEN 3 valve and SAVR. Early adverse events associated with TAVI from the PARTNER 3 were fed into a Markov model that captured longer-term outcomes after TAVI or SAVR. Results: TAVI with SAPIEN 3 improved quality-adjusted life years per patient (+ 1.00) with an increase in costs vs SAVR (€6971 per patient). This meant an incremental cost-effectiveness ratio/quality-adjusted life year of €6952 per patient. The results were robust with TAVI with the SAPIEN 3 valve remaining cost-effective across several sensitivity analyses. Conclusions: TAVI with the SAPIEN 3 valve is cost effective compared to SAVR in patients with sSAS and low surgical mortality risk. These findings can inform policymakers to facilitate policy development in Spain on intervention selection in this patient population.

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