US CoreValve: Cost effectiveness of transcatheter replacement versus surgical replacement in high-risk patients

Previous studies have shown clinical benefits, but also an increased cost to treat patients with symptomatic severe aortic stenosis receiving transcatheter valve replacement (TAVR). There is little consensus regarding the cost-effectiveness for transcatheter versus surgical replacement. 

The present study was aimed to quantify the quality of life, adjusted survival for quality of life, resource utilization, and costs for both; transcatheter and surgical replacement in patients enrolled in the US CoreValve Pivotal high-risk subgroup. The TAVR provided significant clinical benefits versus surgical replacement, improving the quality of life and survival at 12 months. 

In terms of costs, the admission rate was more expensive in patients receiving TAVR but at 12 months the cost of care required for patients was lower, concluding a comparable total monitoring cost at 12 months between both procedures. The costs were more acceptable for those patients who could receive femoral access. 

Conclusion 

In this high-risk population, TAVR provided significant clinical benefits in relation to surgical replacement and costs considered acceptable to United States.

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Matthew R. Reynolds
2014-09-14

Original title: US CoreValve High Risk Trial: Cost-Effectiveness Analysis From a Prospective, Randomized Trial of Transcatheter Aortic Valve Replacement with a Self-Expanding Device Versus Surgical Aortic Valve Replacement in High-Risk Patients with Aortic Stenosis.

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