A Comparison of Payer Costs for Patients with and without Revascularization in Thoracic Endovascular Aortic Repair Stent Grafting Procedures

Speaker(s)

Marti A1, Miller JD2, Clark MA1, Lombardi JV3
1W. L. Gore & Associates, Newark, DE, USA, 2W. L. Gore & Associates, Elkton, MD, USA, 3Cooper University Health Care, Camden, NJ, USA

Presentation Documents

OBJECTIVES:

Little is known about payer costs for patients undergoing Thoracic Endovascular Aortic Repair (TEVAR) stent graft procedures with revascularization. The purpose of this descriptive study is to compare payer costs and short-term outcomes for patients who underwent TEVAR with and without revascularization.

METHODS:

Patients with aortic dissection, aneurysm or trauma who underwent a TEVAR procedure between 1/1/2016 and 1/31/2023 were identified using MERATIVE MARKETSCAN® Treatment Pathways, an online query tool that allows researchers to identify cohorts of patients based on diagnosis and procedure codes and service location. Patients were categorized into one of three groups based on the presence of aortic revascularization procedure codes in the 90-days prior to and including the date of TEVAR: Zone 2 (N=56), Zone 0 or 1 (N=230) and no revascularization (N=761). Patients had to have continuous enrollment during the 90-days pre-and post-TEVAR. Demographic data and distribution of payer costs were explored across revascularization groups. Short term outcomes were examined in the 90-days post-TEVAR discharge.

RESULTS:

Patients with a Zone 0 or 1 revascularization had the highest average costs in the 90-days prior to and including TEVAR at $211,452 (median: $148,962), followed by patients with Zone 2 revascularization at $157,913 (median: $123,736). Those with no revascularization had the lowest average costs at $142,710 (median: $96,304). In the 90-days following TEVAR discharge, patients with Zone 2 revascularization had the lowest percentage of patients with at least one inpatient admission at 16% (N=9), compared to 34% (N=79) and 27% (N=208) for patients with Zone 0/1 and no revascularization, respectively.

CONCLUSIONS:

These data suggest that patients undergoing TEVAR without revascularization may have lower costs in the 90-days prior to and including TEVAR admission compared to those with Zone 0-2 revascularization. More information is needed to confirm cost and outcome differences between TEVAR patients with/ without revascularization.

Code

EE425

Topic

Economic Evaluation

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas