A Real-World Comparison of 1-Year Survival and Expenditures for Transcatheter Aortic Valve Replacements: SAPIEN 3 Versus CoreValve Versus Evolut R

Apr 1, 2021, 00:00
10.1016/j.jval.2020.10.022
https://www.valueinhealthjournal.com/article/S1098-3015(20)34503-4/fulltext
Title : A Real-World Comparison of 1-Year Survival and Expenditures for Transcatheter Aortic Valve Replacements: SAPIEN 3 Versus CoreValve Versus Evolut R
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(20)34503-4&doi=10.1016/j.jval.2020.10.022
First page : 497
Section Title : ECONOMIC EVALUATION
Open access? : No
Section Order : 497

Objectives

New versions of balloon-expandable and self-expandable valves for transcatheter aortic valve replacement (TAVR) have been developed, but few studies have examined the outcomes associated with these devices using national-level data. This study aimed to elucidate the clinical and economic outcomes of TAVR for aortic stenosis in Japan through an analysis of real-world data.

Methods

This retrospective cohort study was performed using data from patients with aortic stenosis who had undergone transfemoral TAVR with Edwards SAPIEN 3, Medtronic CoreValve, or Medtronic Evolut R valves throughout Japan from April 2016 to March 2018. Pacemaker implantation, mortality, and health expenditure were examined for each valve type during hospitalization and at 1 month, 3 months, 6 months, and 1 year. Generalized linear regression models and Cox proportional hazards models were used to examine the associations between the valve types and outcomes.

Results

We analyzed 7244 TAVR cases (SAPIEN 3: 5276, CoreValve: 418, and Evolut R: 1550) across 145 hospitals. The adjusted 1-year expenditures for SAPIEN 3, CoreValve, and Evolut R were $79 402, $76 125, and $75 527, respectively; SAPIEN 3 was significantly more expensive than the other valves (P .001) than SAPIEN 3 at 2.61 (2.07-3.27) and 1.80 (1.53-2.12), respectively. The mortality hazard ratios (95% confidence intervals) for CoreValve and Evolut R were not significant at 1.11 (0.84-1.46) and 1.22 (0.97-1.54), respectively.

Conclusions

SAPIEN 3 users had generally lower pacemaker implantation and mortality but higher expenditures than CoreValve and Evolut R users.

Categories :
  • Cardiovascular Disorders
  • Clinical Outcomes
  • Comparative Effectiveness or Efficacy
  • Health & Insurance Records Systems
  • Medical Devices
  • Medical Technologies
  • Real World Data & Information Systems
  • Specific Diseases & Conditions
Tags :
  • balloon-expandable valve
  • newer generation devices
  • self-expanding valve
  • transcatheter aortic valve replacement
Regions :
  • Asia Pacific (including Oceania)
ViH Article Tags :