Back to Search
Start Over
The Economics of Transcatheter Valve Interventions
- Source :
- The Canadian journal of cardiology. 33(9)
- Publication Year :
- 2016
-
Abstract
- A subset of patients who require correction of a stenotic or incompetent valve are deemed to be at excessive surgical risk, which precludes surgical repair or replacement. Transcatheter valve interventions are viable alternatives in these patients. However, these technologies are costly, and in the setting of a constrained Canadian health care budget, economic value is an important consideration to allow for fair allocation of scarce resources. Accordingly, we review the economic literature on transcatheter valve interventions, targeting a general audience. Our specific goals are highlighting how best to interpret these studies and discuss the implications of these technologies on the Canadian health care system. Transcatheter aortic valve replacement (TAVR) is a cost-effective alternative for inoperable patients who otherwise would receive medical therapy. When compared with surgical aortic valve replacement (SAVR), TAVR is associated with significant reductions in postprocedure hospital resource use, which offsets the substantially higher cost of the TAVR valve system relative to SAVR valves. Although cost-effectiveness estimates for TAVR in high-risk operable candidates vary widely across studies, based on contemporary data from the perspective of the Canadian health care system, TAVR is likely to provide economic value. Recent studies suggest that when compared with medical therapy for severe degenerative mitral regurgitation, the MitraClip (Abbott, Abbott Park, IL) may offer economic value in high-risk patients; however, in the absence of randomized controlled trials, this is speculative. Nonetheless, these transcatheter technologies represent a paradigm shift in the management of valvular disease; their dissemination will have substantial impact in cardiovascular care delivery.
- Subjects :
- Aortic valve
medicine.medical_specialty
medicine.medical_treatment
Cost-Benefit Analysis
Psychological intervention
030204 cardiovascular system & hematology
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Valve replacement
Aortic valve replacement
Health care
Medicine
Humans
030212 general & internal medicine
Hospital Costs
Intensive care medicine
Mitral regurgitation
business.industry
MitraClip
Aortic Valve Stenosis
medicine.disease
medicine.anatomical_structure
Aortic valve stenosis
Aortic Valve
Heart Valve Prosthesis
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 19167075
- Volume :
- 33
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The Canadian journal of cardiology
- Accession number :
- edsair.doi.dedup.....e6e5ae5e1a49d949af3aed2e2abb608b