Verena Veulemans1, Kerstin Piayda1, Shazia Afzal1, Amin Polzin1, Christine Quast1, Christian Jung1, Ralf Westenfeld1, Tobias Zeus1, Malte Kelm2, Katharina Hellhammer3. 1. Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Düsseldorf 40225, Germany. 2. Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Düsseldorf 40225, Germany; CARID (Cardiovascular Research Institute Düsseldorf), Moorenstraße 5, Düsseldorf 40225, Germany. 3. Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich Heine University, Medical Faculty, Moorenstraße 5, Düsseldorf 40225, Germany. Electronic address: Katharina.Hellhammer@med.uni-duesseldorf.de.
Abstract
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has a substantial impact on daily cardiovascular care delivery based on issues such as cost effectiveness and economic value within a restricted health care budget. Until now, potential financial benefits of third generation valve models have not been evaluated in a real-world setting. METHODS AND RESULTS: We identified 204 eligible patients (Jan 2014-Sep 2016) who either received the balloon-expandable Edwards Sapien 3 (ES3) or the self-expandable Medtronic Evolut R (MER). Baseline information, procedural characteristics, 30-day outcome as well as in-hospital costs and reimbursement were collected and analyzed. The major cost driver was initial valve-kit costs with a significantly higher amount in the ES3 group, which was set at 0 with the lower price (ES3/MER: +4390.0€ ± 3.807.0 vs. 0.0€ ± 734.1; p < 0.01). However, initial valve-kit costs were balanced by additional material costs in the MER cohort. Overall costs did not differ significantly between valve models (ES3/MER: x + 13.808.0€ ± 5.595.0 vs. x + 10.681.0€ ± 4.518.0; p = 0.6885) and reimbursement was moderate (ES3/MER: 1.649.7€ vs. 4776.7€). CONCLUSION: Quality, success rate, and costs were comparable between third generation devices. Initial valve-kit costs were significantly higher in the ES3 group, whereas overall costs did not significantly differ between the two valve types.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has a substantial impact on daily cardiovascular care delivery based on issues such as cost effectiveness and economic value within a restricted health care budget. Until now, potential financial benefits of third generation valve models have not been evaluated in a real-world setting. METHODS AND RESULTS: We identified 204 eligible patients (Jan 2014-Sep 2016) who either received the balloon-expandable Edwards Sapien 3 (ES3) or the self-expandable Medtronic Evolut R (MER). Baseline information, procedural characteristics, 30-day outcome as well as in-hospital costs and reimbursement were collected and analyzed. The major cost driver was initial valve-kit costs with a significantly higher amount in the ES3 group, which was set at 0 with the lower price (ES3/MER: +4390.0€ ± 3.807.0 vs. 0.0€ ± 734.1; p < 0.01). However, initial valve-kit costs were balanced by additional material costs in the MER cohort. Overall costs did not differ significantly between valve models (ES3/MER: x + 13.808.0€ ± 5.595.0 vs. x + 10.681.0€ ± 4.518.0; p = 0.6885) and reimbursement was moderate (ES3/MER: 1.649.7€ vs. 4776.7€). CONCLUSION: Quality, success rate, and costs were comparable between third generation devices. Initial valve-kit costs were significantly higher in the ES3 group, whereas overall costs did not significantly differ between the two valve types.
Authors: Katja Bohmann; Christof Burgdorf; Tobias Zeus; Michael Joner; Héctor Alvarez; Kira Lisanne Berning; Maren Schikowski; Albert Markus Kasel; Gesine van Mark; Cornelia Deutsch; Jana Kurucova; Martin Thoenes; Derk Frank; Steffen Wundram; Peter Bramlage; Barbara Miller; Verena Veulemans Journal: J Clin Med Date: 2022-02-23 Impact factor: 4.241