Evidence map›Paper›PMID 30762171›Full record

ArticleHealth economics review2019

A comparative profitability analysis of transcatheter versus surgical aortic valve replacement in a high-volume French hospital.

François Huchet, Jacques Chan-Peng, Fanny d'Acremont, Patrice Guerin, Gael Grimandi, Jean-Christian Roussel, Julien Plessis, Vincent Letocart, Thomas Senage, Thibaut Manigold

Abstract read
In one paragraph

Article in Health economics review, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

François HuchetService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France. dr.fhuchet@gmail.com.ORCID http://orcid.org/0000-0003-2052-7216
Jacques Chan-PengService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France.
Fanny d'AcremontPharmacie Centrale, Hôpital Saint-Jacques, CHU de Nantes, 44093, Nantes, France.
Patrice GuerinService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France.
Gael GrimandiPharmacie Centrale, Hôpital Saint-Jacques, CHU de Nantes, 44093, Nantes, France.
Jean-Christian RousselService de chirurgie cardio-thoracique, Hôpital Nord Laennec, CHU de Nantes, 44800, Saint-Herblain, France.
Julien PlessisService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France.
Vincent LetocartService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France.
Thomas SenageService de chirurgie cardio-thoracique, Hôpital Nord Laennec, CHU de Nantes, 44800, Saint-Herblain, France.
Thibaut ManigoldService de Cardiologie, Hôpital Nord Laennec, Unité d'Hémodynamique et Cardiologie Interventionnelle, CHU de Nantes, Boulevard Professeur Jacques Monod, 44800, Saint-Herblain, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent scientific guidelines have extended the indication for transcatheter aortic valve replacement (TAVR) to patients who present an intermediate risk for surgery and have been so far considered for conventional surgery. We previously demonstrated that the TAVR procedure generated profits despite elevated costs, but comparison with surgery has not been performed. The objective of this study was to assess the profitability of the TAVR procedure compared with conventional surgery in a high-volume French hospital. Consecutive patients eligible for transfemoral TAVR or surgical aortic valve replacement (SAVR) were included retrospectively in this single-centre study between September 2014 and December 2015. The primary endpoint was the profitability of each procedure (defined as the ratio between the profit and total revenues), calculated for each patient. Secondary composite endpoints included major adverse events in the 30 days following procedure and breakdown of costs.

resultsTwo hundred and thirty-eight patients were included in the TAVR group and 341 in the SAVR group. TAVR patients presented higher operative risk scores and more comorbidities. Compared with SAVR, TAVR was associated with higher profits (€2732 ± 1768 per patient vs. €2177 ± 2437 per patient, P < 0.001) but also higher costs (€27,778 ± 4961 vs. €17,813 ± 6071, P < 0.001) resulting in lower profitability (9.3 ± 5.7% vs. 11.7 ± 10.1%, P < 0.001). The price of the bioprosthesis represented 70% of the TAVR total cost.

conclusionsTAVR performed in carefully selected patients was associated with higher profits than SAVR, but also higher costs resulting in lower profitability.

Indexed as

Aortic valve disease, percutaneous interventionCardiovascular diseasesEconomical/cost-effectiveness

Identifiers

PMID30762171
PMCPMC6734332

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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.