Valvular & structural heart disease
Cost-effectiveness of transcatheter tricuspid valve replacement (TTVR) with EVOQUE system in patients with Severe Tricuspid Regurgitation based on TRISCEND II trial
Authors' conclusion
Evoque™ may represent a cost-effective strategy in severe TR patients, however this should be interpreted with caution, as results rely heavily on extrapolated data and are subject to high structural and parameter uncertainty. The projected long-term benefits are largely model driven rather than empirically demonstrated, emphasising the need for extended follow-up data.
Study context
- Population
- Patients with severe Tricuspid Regurgitation (TR); modeled cohort reflected the TRISCEND II population
- Comparison
- Evoque™ TTVR versus optimal medical treatment (OMT) alone over a lifetime horizon
- Outcome
- Incremental life-years and QALYs
- Follow-up
- Lifetime horizon
Methodological detailscost-effectiveness, lifetime horizon, French healthcare perspective, discounted at 2.5% annually
- Cost-effectiveness
- Lifetime horizon
- French healthcare perspective
- Discounted at 2.5% annually
Main finding
As reported in the abstract
Incremental life-years gained (LYG), Evoque™
1.76
Incremental quality-adjusted LYG (QALY), Evoque™
1.63
Further findings
Incremental costs and ICER · lifetime horizon
- Incremental costs, driven by device acquisition and procedure costs
- €39,382
- ICER per LYG
- €22,327/LYG
- ICER per QALY gained
- €24,109/QALY
Scenario: no mortality difference in extrapolations
- ICER
- €86,428/QALY
- Increase
- +258%
Sensitivity analysis
- Model highly sensitive to assumptions on time horizon, utility, discount rate and post-trial mortality extrapolation, leading to major uncertainty
Original publication
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