[Systematic review: Validity and transferability of the results of health-economic evaluations of Transcatheter Aortic Valve Implantation].

AIM

To investigate health-economic evaluations of Transcatheter Aortic Valve Implantation (TAVI).

METHODS

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.

RESULTS

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.