COST-MINIMIZATION AND BUDGET IMPACT ANALYSIS OF THE TRANSCATHETER PULMONARY VALVE VERSUS SURGICAL REPLACEMENT FOR RVOT DYSFUNCTION IN MEXICO
Author(s)
Kyla Jones, BA, MSc1, JUAN VALENCIA, MSc, MD2, Alejandro Sanchez Velasquez, MD3;
1Medtronic, Sr. Principal | Health Economics, Policy and Reimbursement, Northern LatAm, Napoles, Mexico, 2Medtronic, Miami, FL, USA, 3Medtronic PLC, Bogota, Colombia
1Medtronic, Sr. Principal | Health Economics, Policy and Reimbursement, Northern LatAm, Napoles, Mexico, 2Medtronic, Miami, FL, USA, 3Medtronic PLC, Bogota, Colombia
OBJECTIVES: Evaluate the economic impact of Melody™ Transcatheter Pulmonary Valve (TPV) compared to surgical valve replacement for Right Ventricular Outflow Tract (RVOT) dysfunction in the Mexican public sector framework, considering the need for multiple interventions over a patient's lifespan.
METHODS: A systematic literature review (PubMed, Cochrane, CRD, NICE, LILACS) was conducted to assess long-term efficacy and safety. Based on clinical evidence of comparable 5-year survival and reintervention rates, a Cost-Minimization Analysis (CMA) was performed from the Mexican public healthcare perspective. Costs were derived from national public sources (primarily the Mexican Social Security Institute´s Diagnostic Related Groups and Unitary Costs) and adjusted to 2025 Mexican pesos. Deterministic and Probabilistic Sensitivity Analyses (PSA) were executed. A Budget Impact Analysis (BIA) estimated the financial implications of a 10% gradual substitution of surgery by TVP over the 2026-2030 period.
RESULTS: TVP demonstrated comparable long-term survival and freedom from reintervention versus surgery, while significantly reducing ICU stay and hospitalization. The CMA revealed a total cost per patient of $575,828 MXN for TVP vs. $646,000 MXN for surgery, a per-patient saving of $70,172 MXN (10.9% reduction). The PSA confirmed TVP as a cost-saving alternative in >80% of iterations. The BIA estimated a target population of 1,909 patients (2026-2030). The gradual 10% adoption of TPV would result in a total expenditure of $1,193 million MXN vs. $1,233 million MXN in the surgical scenario, generating a cumulative saving of $40 million MXN for the health system.
CONCLUSIONS: The Melody™ TPV is an effective and cost-saving intervention for RVOT dysfunction in Mexico. Access in the public sector offers a minimally invasive solution that optimizes hospital resources, reduces ICU requirements, and provides substantial budgetary relief for the Mexican public health system.
METHODS: A systematic literature review (PubMed, Cochrane, CRD, NICE, LILACS) was conducted to assess long-term efficacy and safety. Based on clinical evidence of comparable 5-year survival and reintervention rates, a Cost-Minimization Analysis (CMA) was performed from the Mexican public healthcare perspective. Costs were derived from national public sources (primarily the Mexican Social Security Institute´s Diagnostic Related Groups and Unitary Costs) and adjusted to 2025 Mexican pesos. Deterministic and Probabilistic Sensitivity Analyses (PSA) were executed. A Budget Impact Analysis (BIA) estimated the financial implications of a 10% gradual substitution of surgery by TVP over the 2026-2030 period.
RESULTS: TVP demonstrated comparable long-term survival and freedom from reintervention versus surgery, while significantly reducing ICU stay and hospitalization. The CMA revealed a total cost per patient of $575,828 MXN for TVP vs. $646,000 MXN for surgery, a per-patient saving of $70,172 MXN (10.9% reduction). The PSA confirmed TVP as a cost-saving alternative in >80% of iterations. The BIA estimated a target population of 1,909 patients (2026-2030). The gradual 10% adoption of TPV would result in a total expenditure of $1,193 million MXN vs. $1,233 million MXN in the surgical scenario, generating a cumulative saving of $40 million MXN for the health system.
CONCLUSIONS: The Melody™ TPV is an effective and cost-saving intervention for RVOT dysfunction in Mexico. Access in the public sector offers a minimally invasive solution that optimizes hospital resources, reduces ICU requirements, and provides substantial budgetary relief for the Mexican public health system.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE504
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Pediatrics, STA: Surgery