LONG-TERM BENEFITS OF EXPANDED ACCESS TO VALVE REPLACEMENT FOR AORTIC STENOSIS PATIENTS

Author(s)

Ermini Leaf D¹, Mattke S¹, Tysinger B², Lakdawalla DN¹
¹University of Southern California, Los Angeles, CA, USA, ²Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA

OBJECTIVES: Aortic valve stenosis is common disease of the heart valves and limits output of blood into the circulation. Symptoms can include chest pain, heart failure, dyspnea, and syncope, and prognosis is poor once symptoms develop. Historically, surgical aortic valve replacement (SAVR) was available to patients with acceptable surgical risk Transcatheter aortic valve replacement (TAVR), was approved in 2011 in the US and expanded access to of valve replacement to patients unsuitable for or unwilling to undergo open-heart surgery This study forecasts the long-term effects of TAVR introduction on medical costs and longevity.

METHODS: The Future Elderly Model microsimulation is used for forecasting individual-level incidence of symptomatic aortic stenosis, treatment, and subsequent mortality outcomes. Mortality, general health transitions, and medical costs are estimated from the Health and Retirement Study and the Medicare Current Beneficiary Survey. A model for aortic valvular disease progression is estimated using Medicare fee-for-service claims. Utilization trends, costs, and mortality effects of valve replacement procedures are derived from published estimates.

RESULTS: The total cost of expanded access to valve replacement through TAVR is forecasted to be $511 billion through 2050. The number of life years saved will be 5.56 million during the same period at a cost of $92,000 per life year.

CONCLUSIONS: Expanded access to valve replacement for aortic stenosis patients will have a net positive benefit over the coming decades.

Conference/Value in Health Info

2020-05, ISPOR 2020, Orlando, FL, USA

Value in Health, Volume 23, Issue 5, S1 (May 2020)

Code

PCV22

Topic

Clinical Outcomes, Economic Evaluation, Medical Technologies

Topic Subcategory

Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Medical Devices, Relating Intermediate to Long-term Outcomes

Disease

Cardiovascular Disorders, Medical Devices

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