Cost Savings Analysis of Implementing Benchmark Best Practices for TAVI Patients in Europe

Speaker(s)

Frank D1, Durand E2, Spence M3, Vasa-Nicotera M4, Saia F5, Muir D6, Wood D7, Urbano C8, Bouchayer D9, Iliescu VA10, Saint Etienne C11, Leclercq F12, Asmarats Serra L13, Lüske C14, Hachaturyan V15, Wesselink W16, Rakova R17, Kurucova J17, Bramlage P15, Lauck S7
1University Clinical Centre Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany, 2Univ Rouen Normandie, Rouen, Normandie, France, 3Mater Private Network, Dublin, Leinster, Ireland, 4Hospital Sindelfingen-Böblingen, Sindelfingen, Baden-Württemberg, Germany, 5University of Bologna, Bologna, Italy, 6James Cook University Hospital, Middlesbrough, UK, 7University of British Columbia, Vancouver, BC, Canada, 8Hospital Regional Universitario de Málaga, Malaga, Spain, 9The Clinique de l'Infirmerie Protestante, Lyon, Germany, 10University of Medicine and Pharmacy Carol Davila, Department of Cardiology, București – Ilfov, Romania, 11Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, Auvergne-Rhône-Alpes, France, 12Montpellier University Hospital, Montpellier, France, 13Hospital de la Santa Creu i Sant Pau, Instituto de Investigación Biomédica Sant Pau, Barcelona, B, Spain, 14Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany, 15Institute for Pharmacology and Preventive Medicine, Cloppenburg, Niedersachsen, Germany, 16Edwards Lifesciences, Prague, Czech Republic, 17Edwards Lifesciences, Prague, Hlavní město Praha, Czech Republic

Presentation Documents

OBJECTIVES: The BENCHMARK registry demonstrated that implementing best practices into standard of care for patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) reduced total hospital length of stay (LoS) without compromising 30-day safety. Here, we aimed to evaluate the cost savings of implementing BENCHMARK best practices in Germany, France, Italy, and Spain.

METHODS: Patient data from the BENCHMARK registry were used, excluding patients from the Czech Republic, Romania and Austria due to the limited availability of cost data in these countries. Total costs included the daily cost per patient of intensive care unit (ICU), coronary care unit (CCU), and general ward stay, procedural parameters, and management of periprocedural complications. The costs were derived from available literature estimates. Weighted costs were calculated based on the number of patients in all considered countries to estimate potential cost savings per patient.

RESULTS: Overall, the cost associated with LoS reduction was €1 417 per patient. Cost attributable to 30-day clinical events were €294 for permanent pacemaker implantation (rate difference pre vs. post BENCHMARK: -6.1%, p<0.001) and €145 for major vascular complication (-1.9%, p=0.036). When accounting for all clinical events, including coronary artery obstruction requiring intervention, disabling stroke, life-threatening bleeding, acute kidney injury stage 2 or 3, as well as potential minor expenditures, additional cost savings at 30 days were €411 per patient. Cost savings from procedural parameters were €546 on average. Total cost saving reflecting the BENCHMARK best practices were €2 374 per patient, a 26% relative reduction.

CONCLUSIONS: Implementing BENCHMARK best practices in four European countries resulted in significant cost savings. This illustrates a successful case study of how a minimal invasive technology combined with its optimization program may improve resource utilization and lead to efficiency gains in the healthcare environment. These results should be informative for clinicians, policymakers and healthcare budget holders.

Code

EE389

Topic

Clinical Outcomes, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment, Comparative Effectiveness or Efficacy, Registries

Disease

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