Transcatheter aortic valve replacement (TAVR) is about as cost effective as other common cardiovascular procedures, according to results of the PARTNER B cost-effectiveness substudy, which were presented today at the American College of Cardiology meeting in New Orleans. (The main results of PARTNER B, which studied the safety and efficacy of TAVR in patients with severe aortic stenosis who were not candidates for surgical treatment, were presented and published last year.)
Matthew Reynolds reported that the admission cost of TAVR, including both hospital and physician fees, as well as an estimated $30,000 cost for the device, was $78,000. In the following 12 months, patients in the control group were twice as likely to be hospitalized and had 20 hospital days compared to 9 in the TAVR group. The followup costs at 1 year were $29,352 in the TAVR group compared to $52,724 in the control group.
The investigators projected the life expectancy of patients in TAVR as 3.11 years and the control group as 1.23 years. They then calculated the cost effectiveness of TAVR versus control as $50,000 per life year. However, when they calculated the quality-adjusted life years the incremental cost of TAVR was $79,837.
In his summary Reynolds said that the “overall 1-year costs remained substantially higher with TAVR.” Reynolds said that the cost-effectiveness of TAVR was better than dialysis and comparable to AF ablation and dabigatran.
He concluded: “For patients with severe aortic stenosis who are unsuitable for surgical AVR, TAVR significantly increases life expectancy at an incremental cost per life year gained well within accepted values for commonly used cardiovascular technologies.”
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