Wolf Sarah, Fischer Stefan
Ludwig Boltzmann Institut für Health Technology Assessment, Garnisongasse 7/20, 1090, Wien, Österreich.
Wien Med Wochenschr. 2019 Sep;169(11-12):293-303. doi: 10.1007/s10354-018-0656-9. Epub 2018 Aug 23.
To investigate health-economic evaluations of Transcatheter Aortic Valve Implantation (TAVI).
Systematic literature search of health-economic evaluations of TAVI comparing Standard Management (Medical Management in combination with Balloon Aortic Valvuloplasty) in inoperable patients and to Surgical Aortic Valve Replacement in operable patients with intermediate/high surgical risk. Incremental cost-effectiveness ratios have been adjusted to Austrian price level (2016). The studies were evaluated according to their relevance and quality.
15 health-economic evaluations were identified. Thereof, eight analyses were rated as sufficiently relevant and of high quality. Results showed that TAVI compared to Standard Management is cost-effective in only two out of six analyses and resulted in controversial results compared to Surgical Aortic Valve Replacement. Sensitivity analyses showed that particularly the inclusion of costs treating serious complications (i. e. stroke) or of the costs of the TAVI-procedure had significant impacts on the cost-effectiveness results.
研究经导管主动脉瓣植入术（TAVI）的卫生经济学评价。
系统检索TAVI的卫生经济学评价，比较标准治疗（药物治疗联合球囊主动脉瓣成形术）用于无法手术的患者，以及外科主动脉瓣置换术用于手术风险中/高的可手术患者。增量成本效益比已根据奥地利物价水平（2016年）进行调整。根据研究的相关性和质量对其进行评估。
共识别出15项卫生经济学评价。其中，八项分析被评为相关性充分且质量较高。结果显示，与标准治疗相比，TAVI仅在六项分析中的两项中具有成本效益，与外科主动脉瓣置换术相比，结果存在争议。敏感性分析表明，尤其是纳入治疗严重并发症（即中风）的成本或TAVI手术的成本对成本效益结果有显著影响。
