OBJECTIVES: Extant economic evidence has underscored TAVI as a cost-effective or dominant intervention in the treatment of symptomatic severe aortic stenosis. However, the relative economic value of TAVI compared to other interventions for cardiovascular disease (CVD) and oncology remains uncertain. This study aims to compare and benchmark the reported ICERs of TAVI relative to other approved interventions in CVD and Oncology across France, Germany, UK, Italy and Spain ( EU5).

METHODS: A targeted literature review was performed in accordance with a pre-specified protocol to identify cost-effectiveness studies in CVD and oncology from the Tufts CEA Registry. The search was conducted separately in the “Ratios” and the “Methods” sections of the registry, using keywords on population and intervention and for the period 2012-2022. Included intervention types were medical device, medical procedure, pharmaceutical, surgical, and diagnostic.

RESULTS: The final sample consisted of 98 studies reporting 171 ICERs. 12.3% of studies evaluated TAVI intervention whilst 28.1% evaluated CVD and 59.6% oncology interventions. Majority of the ICERs for the three groups were in Quadrant 2 (more costly, more effective) of the cost-effectiveness plane. TAVI had the largest proportion of ICERs (52%) in the 0 – 25k USD/QALY range. At different thresholds (US$ 0K/QALY to US$ 75,000/QALY), the probability that TAVI is cost-effective did not differ significantly from other CVD interventions (p-value range: 0.267-0.299). Considering a US$ 50,000/QALY threshold, both TAVI (76.2%) and other CVD interventions (91.7%) had a significantly higher proportion of ICERs relative to Oncology (46.1%) (p-value 0.006 and <0.001 respectively).

CONCLUSIONS: This study demonstrates that the economic evaluation of TAVI is comparable to other CVD interventions whilst both have a favorable economic evaluation relative to oncology interventions in the EU5. In summary, TAVI seems to be a better value for money than many standard interventions, which is informative for healthcare policymakers and budget holders.