Transcatheter Aortic Valve Implantation vs Surgery in Symptomatic Severe Aortic Stenosis Patients at Low Surgical Mortality Risk in Belgium: An Updated Cost-Utility Analysis Based on the 5-Year Data From the Partner 3 Trial

Author(s)

Callebaut B1, Vermeersch S2, Bromilow T3, Sellitto V4, Candolfi P5
1Hict, Ghent, VOV, Belgium, 2Hict, Gent, VOV, Belgium, 3York Health Economics Consortium (YHEC), York, NYK, UK, 4Edwards Lifesciences, Milan, Milan, Italy, 5Edwards Lifesciences Sàrl, Nyon, VD, Switzerland

OBJECTIVES: Growing evidence supports transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement (SAVR) for patients with symptomatic severe aortic stenosis (sSAS). 5-year PARTNER 3 trial data confirms benefits of TAVI with SAPIEN 3 compared to SAVR in low-risk sSAS patients. Previous cost-utility analyses based on 2-year outcomes found that TAVI with SAPIEN 3 was cost-effective versus SAVR in several European countries, including in Belgium where it was dominant over a lifetime horizon [Dubois et al., 2023]. This analysis assesses SAPIEN 3’s economic benefits over SAVR in low-risk Belgian sSAS patients, using the 5-year PARTNER 3 trial data.

METHODS: A previously published Markov-based cost-utility model which had been validated for the Belgian population was used. Clinical outcomes from the PARTNER 3 trial up to 5 years were incorporated, and the model was adapted to the Belgian context with updated cost estimates from the Belgian National Healthcare System perspective. The model considered a lifetime horizon, comparing changes in direct healthcare costs and quality-adjusted life years (QALYs) between TAVI and SAVR in low-risk sSAS patients.

RESULTS: TAVI with SAPIEN 3 is associated with both clinical and economic benefits over SAVR: TAVI was cost-saving (€4107 per patient) and generated more QALYs (an additional 0.46 per patient). These findings are consistent with those reported in the previous cost-utility analysis published by Dubois et al. [2023] with TAVI with SAPIEN 3 remaining dominant versus SAVR over a lifetime horizon and across several scenarios analyses.

CONCLUSIONS: The analysis with 5-year data from the PARTNER 3 trial confirms that TAVI with SAPIEN 3 is a dominant alternative to SAVR for Belgian sSAS patients at low risk of surgical mortality. These results provide valuable insights for clinicians, policymakers, and budget holders in optimizing patient outcomes and healthcare resource allocation.

Conference/Value in Health Info

2024-11, ISPOR Europe 2024, Barcelona, Spain

Value in Health, Volume 27, Issue 12, S2 (December 2024)

Code

EE374

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Medical Devices, Surgery

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