Randomised controlled trial
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
- Economic evaluation (cost-effectiveness analysis) of the PARTNER 3 randomised trial
- economic substudy
- Markov model
- US health care system perspective
- lifetime horizon
Authors' conclusion
For patients with severe aortic stenosis and low surgical risk similar to those enrolled in the PARTNER 3 trial, transfemoral TAVR with the SAPIEN 3 valve is cost saving compared with SAVR at 2 years and is projected to be economically attractive in the long run as long as there are no substantial differences in late death between the 2 strategies.
Study context
- Population
- Patients with severe aortic stenosis at low surgical risk who underwent valve replacement, enrolled in the USof 1000 randomised
- Participants
- 929 patients
- Comparison
- Transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR)
- Primary endpoint
- Cost per quality-adjusted life-year gained (lifetime cost-effectiveness)
Primary result
As reported in the abstract
2-year costs and quality-adjusted life-years · 2 years
- TAVR
- cost savings $2030 per patient (95% CI -$6222 to $1816)
- TAVR
- gain 0.05 quality-adjusted life-years (95% CI −0.003 to 0.102)
- Base case: TAVR projected economically dominant; probability ICER <$50 000/QALY gained
- 95%
Further findings
Index costs
- Procedural costs higher with TAVR
- nearly $19 000
- Total index hospitalization costs higher with TAVR
- $591
Sensitivity to long-term survival
- A modest long-term survival advantage with SAVR would render SAVR cost-effective (not cost saving) vs TAVR
Original publication
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. Circulation. Published 8 May 2023. doi:10.1161/circulationaha.122.062481
Summarised from the published abstract; every number is checked against it