Objectives: Economic evaluations of new technologies often assess the cost-effectiveness for a typical patient or budget impact for payers. This analysis projects potential costs, health gains, and productivity gains at a national population-level based on more patients receive a surgical tissue valve vs. mechanical valve replacement.

Methods: A national-level simulation model was developed to estimate the societal impact of Surgical Aortic Valve Replacement (SAVR) with mechanical versus tissue valves among heart valve disease (HVD) patients over a patient's remaining lifetime. The base-case scenario evaluated the economic impact given current utilization of mechanical (96% for HVD patients age 40-49 and 88% for age 50-59) vs. tissue valves, while the alternative future scenario simulated equal use across the population. Epidemiological inputs were collected from the literature. Demographic and labor economic inputs were from China Statistical Yearbook 2020. Simulation cohorts included HVD patients aged 40-49 years old and 50–59 years old. Estimates of utilization of SAVR valves by age and personal disposable income were based on expert judgment. Economic outcomes included direct lifetime costs (SAVR costs, clinical event costs, anticoagulation monitoring (ACM) costs), indirect costs (productivity loss due to ACM visits), the value of quality-of-life gains, and economic gains from post-SAVR labor force participation.

Results: The model projects that there are 7.9 million HVD patients in China who would be eligible for SAVR. Increasing the utilization of tissue valves to 50% would provide aggregate lifetime economic gains of USD100 billion in the 50-59 age group and USD67 billion in the 40-49 age group. The economic gains from great tissue value use were due to avoiding ACM costs, improved quality of life, and greater post-SAVR labor force participation.

Conclusions: A population-level macroeconomic macro simulation model projected substantial aggregate economic gain—USD$167 billion—for the HVD patient population in China.