Costs of Transcatheter Versus Surgical Aortic Valve Replacement in Brazil

Speaker(s)

Etges AP1, Costa R2, Sarmento Leite R2, Siqueira D3, Saad G3, Saad R4, Casiraghi Y4, Polanczyk CA1
1PEV Healthcare Consulting, Porto Alegre, RS, Brazil, 2Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista (SBHCI), Brazil, São Paulo, SP, Brazil, 3Institute Dante Pazzanese, Sao Paulo, SP, Brazil, 4Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

Presentation Documents

OBJECTIVES: This study evaluates the in-hospital and 1-year follow-up costs of patients undergoing transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in reference centers in Brazil. It was developed with the coordination of the Brazilian Hemodynamic Society to sustain potential strategies to reimburse the TAVR at a national level.

METHODS: This is preliminar analysis of an ongoing multicenter microcosting study which followed the method Time-driven Activity-based Costing to estimate the procedure costs combined with patient-level hospitalization cost using as reference the daily costs from each center. All patients submitted to TAVR from January 2020 to July 2022 in the 3 participant centers have the data included in the study, and a similar number of arbitrary SAVR cases were selected. Descriptive cost analysis was followed by an opportunity cost derived from the variability in length of hospitalization stay and valve acquisition costs. All the cost is presented in International Dollars.

RESULTS: Our sample is composed of 409 cases (197 TAVR and 212 SAVR). The TAVR patients registered a mean STS-PROM-Score of 3.48, while SAVR’ 1.57. The mean cost per TAVR was $30,507(SD $11,603) and SAVR $19,133(SD $7,684), and the mean length of hospitalization(LoS) stay was 5(SD 6) and 10(SD 10) days, respectively. Considering the difference in LoS between the procedures, by reducing all to the TAVR parameter, it will be possible to double the procedures. The supply proportion in TAVR cases accounted for 87%, while in SAVR 41%, and among the TAVR cases, the valve acquisition varied around 700% among cases. If all cases were performed with the mean acquisition price of $27,288, 12 additional procedures could be delivered.

CONCLUSIONS: This study reports real-world economic information about TAVR and SAVR in Brazil. The opportunity-cost analysis demonstrates how strategies to reduce variability could result in greater access to health technologies.

Code

EE314

Topic

Economic Evaluation, Health Policy & Regulatory

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis, Reimbursement & Access Policy

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory)