TCT: Hospitalization costs for TAVR total $51K, finds German study

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 - Roll of Money

MIAMI—Total hospitalization costs with transcatheter aortic valve replacement (TAVR) amount to approximately €40,000 ($51,713), mainly driven by length of stay and valve costs, according to a German scientific poster presented Oct. 23 at the Transcatheter Cardiovascular Therapeutics (TCT) conference.

With this study, Diana Blanche De Graeve, PhD, a health economist at the University of Antwerp in Antwerp, Belgium, and colleagues sought to calculate and analyze the costs associated with patients with severe aortic stenosis, but who are not good candidates for surgical aortic valve replacement and are treated with TAVR.

The researchers retrospectively collected data from all patients who underwent a transcatheter aortic valve insertion in the University Hospital Antwerp from December 2007 until June 2011. They retrieved costs of hospitalization on the basis of invoices and patient characteristics from medical records. Costs were actualized to 2011 using 2011 tariffs and determinants analyzed through Wilcoxon rank sum tests and Spearman rho's correlation.

The study included 89 patients. The researchers performed analyses on 86 patients with complete cost data. All interventions were done by a single physician using Core Valve (Medtronic). The mean age of the patients was 82 years, and 73 percent of patients were classified as New York Heart Association 3 and 4.

De Graeve et al found that the mean costs amount to €38,521 ($49,803) with median costs only slightly smaller (€37,079/$47,935 U.S.). The costs of the valve (€17,090 per valve/$22,094 per valve) and daily nursing and hotel costs (€594 per day/$767 per day) are most “important,” amounting to respectively 46 percent and 26 percent of total costs, according to the researchers.

“There is weak evidence of a learning effect: costs decrease somewhat over the years,” they wrote. Specifically, the mean rank of total costs was €47.77 ($61.76) between 2007 and 2009, €44.12 ($57.04) in 2010 and €32.44 ($41.94).

Pulmonary hypertension, hyperlipidemia and previous pacemaker have a significant association with costs as well. The mean rank of total costs was €56.21 ($72.67) for patients with pulmonary hypertension, as opposed to €41.03 ($53.04) for those without. The mean rank of total costs was €32.59 ($42.13) for patients with hyperlipidemia, as opposed to €49.05 ($63.51) for those without. The mean rank of total costs was €12 ($15.51) for patients with a previous pacemaker, as opposed to €44.25 ($57.20) for those without.

The researchers also found that the distribution of costs is not significantly different for other background characteristics of the patient. “Most patient characteristics are not significantly related to total hospitalization costs,” the researchers concluded.