The Particulars: Recent cost-effective analyses have compared surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR), but these studies may not represent outcomes that can be expected in broad clinical practice. Use of Markov decision analytic modeling may be more representative of expectations.

Data Breakdown: For a study, researchers developed a Markov decision analytic lifetime model with Monte Carlo simulations in patients considered at “high risk” for SAVR. Using the model, TAVR was associated with a lifetime cost of $81,548 and 3.54 quality-adjusted life years (QALYs). SAVR was associated with a lifetime cost of $99,641 and an effectiveness of 3.45 QALYs.

Take Home Pearl: TAVR appears to be associated with significantly lower costs and small gains in QALYs when compared with SAVR among high-risk patients requiring aortic valve replacement.