ArticleBMJ open2012
A cost-utility analysis of transcatheter aortic valve implantation in Belgium: focusing on a well-defined and identifiable population.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [Systematic review: Validity and transferability of the results of health-economic evaluations of Transcatheter Aortic Valve Implantation].Wiener medizinische Wochenschrift (1946) · 2019Pooled it
- Systematic review of model-based economic evaluations of heart valve implantations.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Pooled it
- Local versus general anesthesia for transcatheter aortic valve implantation (TAVR)--systematic review and meta-analysis.BMC medicine · 2014Pooled it
- Cost-Effectiveness of Transcatheter Aortic Valve Replacement With a Self-Expanding Prosthesis Versus Surgical Aortic Valve Replacement.Journal of the American College of Cardiology · 2016Trial
- Cost-effectiveness of transcatheter aortic valve implantation in older patients with aortic stenosis: a large-scale retrospective cohort study using an administrative claims database.Heart and vessels · 2026Article
- Cost-effectiveness analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at low risk of surgical mortality in Sweden.Upsala journal of medical sciences · 2025Article
- Article
- Cardiac Health Assessment Using a Wearable Device Before and After Transcatheter Aortic Valve Implantation: Prospective Study.JMIR mHealth and uHealth · 2024Article
- Cost-utility analysis of TAVI compared with surgery in patients with severe aortic stenosis at low risk of surgical mortality in the Netherlands.Cost effectiveness and resource allocation : C/E · 2024Article
- Cost-effectiveness analysis of transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis at low risk of surgical mortality in Sweden.Upsala journal of medical sciences · 2024Article
- The economics of TAVI: A systematic review.International journal of cardiology. Heart & vasculature · 2023Review
- Cost-Utility Analysis of Transcatheter Aortic Valve Implantation versus Surgery in High-Risk Severe Aortic Stenosis Patients in Thailand.ClinicoEconomics and outcomes research : CEOR · 2022Article
- TAVR, SAVR and MI-AVR. Good Things Come to Those Who Wait.Journal of clinical medicine · 2020Article
- Transcatheter Versus Surgical Aortic Valve Replacement Episode Payments and Relationship to Case Volume.The Annals of thoracic surgery · 2018Article
- Cost-effectiveness analysis in cardiac surgery: A review of its concepts and methodologies.The Journal of thoracic and cardiovascular surgery · 2018Review
- The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Article
- Transcatheter aortic valve implantation economics: a grisly reality.Annals of cardiothoracic surgery · 2017Article
- Two-year post-discharge costs of care among patients treated with transcatheter or surgical aortic valve replacement in Germany.BMC health services research · 2017Article
- Extrapolation of Survival Curves from Cancer Trials Using External Information.Medical decision making : an international journal of the Society for Medical Decision Making · 2017Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with severe aortic stenosis and coexisting non-cardiac conditions may be at high risk for surgical replacement of the aortic valve or even be no candidates for surgery. In these patients, transcatheter aortic valve implantation (TAVI) is suggested as an alternative. Results of the PARTNER (Placement of AoRTic TraNscathetER Valve) trial comparing the clinical effectiveness of TAVI with surgical valve replacement and standard therapy were published. The authors assessed the cost-effectiveness of TAVI in Belgium.
methodsA Markov model of incremental costs, effects (survival and quality of life) and incremental cost-effectiveness of TAVI was developed. The impact on survival, number of events and quality of life was based on the PARTNER trial. Costs per event were context specific.
resultsIn high-risk operable patients, even if the minor differences in 30-day and 1-year mortality are taken into account, the incremental cost-effectiveness ratio (ICER) remains on average above €750 000 per quality-adjusted life-year (QALY) gained (incremental cost: €20 400; incremental effect: 0.03 QALYs). In inoperable patients, an ICER of €44 900 per QALY (incremental cost: €33 200; incremental effect: 0.74 QALYs) is calculated, including a life-long extrapolation of the mortality benefit. This result was sensitive to the assumed time horizon. The subgroup of anatomically inoperable patients had better outcomes than medically inoperable patients, with ICERs decreasing more than €10 000/QALY.
conclusionsIt is inappropriate to consider reimbursement of TAVI for high-risk operable patients. Reimbursing TAVI in inoperable patients in essence is a political decision. From an economic perspective, it would be prudent to first target patients that are inoperable because of anatomical prohibitive conditions. In the search for evidence, the authors identified non-published negative results from a randomised controlled TAVI trial. The study sponsor should be more willing to share this information to allow balanced evaluations and policy recommendations. Payers should require these data before taking reimbursement decisions.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.