An exploratory cost-effectiveness analysis of a novel tissue valve compared with mechanical valves for surgical aortic valve replacement in subgroups of people aged 55-64 and 65+ with aortic stenosis in the UK

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(9):1087-1099. doi: 10.1080/14737167.2023.2249611. Epub 2023 Aug 28.

Abstract

Objective: Exploratory analysis to conceptualize and evaluate the potential cost-effectiveness and economic drivers of using a novel tissue valve compared with mechanical heart valves for surgical aortic valve replacement (SAVR) in people aged 55-64 and 65+ with aortic stenosis (AS) from a National Health Service (NHS) UK perspective.

Methods: A decision-analytic model was developed using a partitioned survival model. Parameter inputs were obtained from published literature. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted to explore the uncertainty around the parameters.

Results: The novel tissue valve was potentially associated with higher quality-adjusted life years (QALYs) of 0.01 per person. Potential cost savings were greatest for those aged 55-64 (£408) versus those aged 65+(£53). DSA indicated the results to be most dependent on relative differences in general mortality, procedure costs, and reoperation rates. PSA estimated around 75% of the iterations to be cost-effective at £20,000 per QALY for those aged 55-64, and 57% for those aged 65+.

Conclusions: The exploratory analysis suggests that the novel tissue valve could be a cost-effective intervention for people over the age of 55 with AS who are suitable for SAVR in the UK.

Keywords: NHS; Surgical aortic valve replacement; aortic stenosis; bioprosthetic valve; cost-effectiveness; health economics.

MeSH terms

  • Aortic Valve / surgery
  • Aortic Valve Stenosis* / surgery
  • Cost-Benefit Analysis
  • Cost-Effectiveness Analysis
  • Heart Valve Prosthesis Implantation* / methods
  • Humans
  • Male
  • Prostate-Specific Antigen
  • State Medicine
  • Treatment Outcome
  • United Kingdom

Substances

  • Prostate-Specific Antigen