Costs* | QALYs† | ICER‡ | |
---|---|---|---|
Base case | |||
TAVI | 2.81 | ||
Procedural and redo costs | £19368.32 | ||
Complication costs (after 2 years) | £2125.14 | ||
Annual medication costs (after 2 years) | £82.63 | ||
Long-term care and rehospitalisation costs | £31422.01 | ||
TAVI total 10 year cost | £52593.02 | ||
SAVR | 2.75 | ||
Procedural and redo costs | £20380.03 | ||
Complication costs | £2709.60 | ||
Annual medication costs | £113.62 | ||
Long-term care and rehospitalisation costs | £31095.10 | ||
SAVR total 10 year costs | £53943.40 | ||
Incremental QALY | −£1350.38 | 0.063 | TAVI dominates |
Life years | 4.42 | 4.30 | |
Incremental life years | −£1350.38 | 0.13 | TAVI dominates |
Deterministic sensitivity analyses | Incremental cost | Incremental QALY | ICER |
Costs | |||
Procedural costs +25% | −£1689.63 | 0.063 | TAVI dominates |
Procedural costs −25% | −£1011.13 | 0.063 | TAVI dominates |
TAVI tariff price £25,000 | £7294.12 | 0.063 | £116231.63 |
TAVI procedure costs +25% | £3393.00 | 0.063 | £54067.41 |
TAVI length of stay alternative values | £689.62 | 0.063 | £10989.06 |
Complication costs +25% | −£1497.51 | 0.063 | TAVI dominates |
Complication costs -25% | −£1203.25 | 0.063 | TAVI dominates |
Hospitalisation costs +25% | −£1336.36 | 0.063 | TAVI dominates |
Hospitalisation costs -25% | −£1364.40 | 0.063 | TAVI dominates |
Weekly care costs by NYHA +25% | −£1264.95 | 0.063 | TAVI dominates |
Weekly care costs by NYHA −25% | −£1435.81 | 0.063 | TAVI dominates |
Utility | |||
Alternative utility values | −£1350.38 | 0.066 | TAVI dominates |
Complication utility decrement +25% | −£1350.38 | 0.058 | TAVI dominates |
Event probabilities | |||
TAVI extreme (‘worst case’) scenario complication Probabilities | £99.95 | 0.009 | £11,307.18 |
UK Registry TAVI complication probabilities | −£1715.18 | 0.076 | TAVI dominates |
Hospitalisation rates by NYHA +25% | −£1336.36 | 0.063 | TAVI dominates |
Hospitalisation rates by NYHA −25% | −£1364.40 | 0.063 | TAVI dominates |
Other | |||
Time horizon=5 years | −£1452.91 | 0.045 | TAVI dominates |
Discount rate 1% for costs and QALYs | −£1323.06 | 0.067 | TAVI dominates |
Discount rate 6% for costs and QALYs | −£1373.57 | 0.059 | TAVI dominates |
Probabilistic sensitivity analysis—mean Monte Carlo simulation results | |||
TAVI | £52593.08 | 2.82 | |
SAVR | £54004.89 | 2.75 | |
Incremental | −£1411.09 | 0.066 | TAVI dominates |
NYHA, New York Health Association classification. SAVR, surgical aortic valve implantation; TAVI, transcatheter aortic valve implantation.
*All costs at 2011 prices.
†Quality adjusted life years.
‡Incremental cost-effectiveness ratio.