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HEALTH TECHNOLOGY ASSESSMENTS REPORTING COST-EFFECTIVENESS OF TRANSCATHETER AORTIC VALVE IMPLANTATION

Published online by Cambridge University Press:  05 August 2016

Sanjeewa Kularatna ,
Joshua Byrnes ,
Merehau Cindy Mervin  and
Paul A. Scuffham
Sanjeewa Kularatna
Affiliation:
Centre for Applied Health Economics, School of Medicine, Griffith [email protected] Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University
Joshua Byrnes
Affiliation:
Centre for Applied Health Economics, School of Medicine, Griffith [email protected] Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University
Merehau Cindy Mervin
Affiliation:
Centre for Applied Health Economics, School of Medicine, Griffith [email protected] Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University
Paul A. Scuffham
Affiliation:
Centre for Applied Health Economics, School of Medicine, Griffith [email protected] Population and Social Health Research Program, Menzies Health Institute Queensland, Griffith University
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Abstract

Objectives: Made available since 2002, transcatheter aortic valve implantation (TAVI) is a minimally invasive new intervention which can provide significant survival improvement to patients with aortic stenosis. However, TAVI is expensive and currently not reimbursed by many governments. Some governments and institutions have been conducting health technology assessments (HTAs) to inform their reimbursement decisions. The aim of the present study is to review HTAs that have relied on a cost-effectiveness analysis to inform reimbursement decisions of TAVI.

Methods: A systematic literature review was conducted among published literature as well as reports released by HTA agencies. Predetermined inclusion and exclusion criteria, following the Preferred Reporting System for Systematic Reviews and Meta-Analysis guidelines, were used to select relevant HTAs. The selected papers were assessed against the Consolidated Health Economic Evaluation Reporting Standards.

Results: HTAs on TAVI from three countries were available for this review: Canada, Belgium, and the United Kingdom. All three HTAs used the Placement of Aortic Transcatheter Valve (PARTNER) trial data with Markov models to estimate the incremental cost effectiveness ratio. The three HTAs recommended conditional reimbursement for TAVI for otherwise inoperable patients. The HTAs did not use clear methods to estimate the health-related utility which ultimately affected their cost-effectiveness results. The UK HTA showed the best value for money (US$20,416 per quality-adjusted life-year).

Conclusion: All studies found TAVI to be more costly and less effective for high-risk patients suitable for surgery, whereas TAVI was consistently found to be cost effective for otherwise inoperable patients.

Keywords

TAVIHTA
Type
Assessments
Information
International Journal of Technology Assessment in Health Care , Volume 32 , Issue 3 , 2016 , pp. 89 - 96
Copyright
Copyright © Cambridge University Press 2016 

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