{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:23:43Z","timestamp":1793391823978,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100016304","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016304","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In the recent Evolut Low Risk randomized trial, transcatheter aortic valve implantation (TAVI) was shown to be non-inferior to surgery (SAVR) regarding the composite end point of all-cause mortality or disabling stroke at 24\u00a0months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>To evaluate the cost-effectiveness of self-expandable TAVI in low-risk patients, using the French healthcare system as the basis for analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Mortality, health-related quality of life, and clinical event rates through two-year follow-up were derived from trial data (<jats:italic>N<\/jats:italic>\u2009=\u2009725 TAVI and <jats:italic>N<\/jats:italic>\u2009=\u2009678 SAVR; mean age: 73.9\u00a0years; mean STS-PROM: 1.9%). Cost inputs were based on real-world data for TAVI and SAVR procedures in the French healthcare system. Costs and effectiveness as quality-adjusted life years (QALYs) were projected to lifetime via a decision-analytic model under assumption of no mortality difference beyond two years. The discounted incremental cost-effectiveness ratio (ICER) was evaluated against a willingness-to-pay threshold of \u20ac50,000 per QALY gained. Deterministic and probabilistic sensitivity analyses were conducted, including assumptions about differential long-term survival.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>For the base case, mean survival was 13.69 vs 13.56 (+\u20090.13) years for TAVI and SAVR, respectively. Discounted QALYs were 9.34 vs. 9.21 (+\u20090.13) and discounted lifetime costs \u20ac52,267 vs. \u20ac51,433 (+\u2009\u20ac833), resulting in a lifetime ICER of \u20ac6368 per QALY gained. In probabilistic sensitivity analysis, TAVI was found dominant or cost-effective in 74.4% of samples.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TAVI in patients at low surgical risk is a cost-effective alternative to SAVR in the French healthcare system. Longer follow-up data will help increase the accuracy of lifetime survival projections.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s10198-023-01590-x","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T17:02:17Z","timestamp":1685466137000},"page":"447-457","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Cost-effectiveness of transcatheter aortic valve implantation in patients at low surgical risk in France: a model-based analysis of the Evolut LR trial"],"prefix":"10.1007","volume":"25","author":[{"given":"Didier","family":"Tch\u00e9tch\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coline Dubois","family":"de Gennes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Cormerais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P.","family":"Geisler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Dutot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Wilquin-Bequet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Breau-Brunel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9ranger","family":"Lueza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan B.","family":"Pietzsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"1590_CR1","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","volume":"380","author":"MJ Mack","year":"2019","unstructured":"Mack, M.J., Leon, M.B., Thourani, V.H., Makkar, R., Kodali, S.K., Russo, M., Kapadia, S.R., Malaisrie, S.C., Cohen, D.J., Pibarot, P., Leipsic, J., Hahn, R.T., Blanke, P., Williams, M.R., McCabe, J.M., Brown, D.L., Babaliaros, V., Goldman, S., Szeto, W.Y., Genereux, P., Pershad, A., Pocock, S.J., Alu, M.C., Webb, J.G., Smith, C.R.: Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. 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(Jan B. Pietzsch, Benjamin P. Geisler) and Amaris Consulting (Coline Dubois de Gennes, Manon Breau-Brunel, B\u00e9ranger Lueza), provided health-economic consulting services to Medtronic Plc. Coline Dubois de Gennes is currently employed by GlaxoSmithKline at the time of final approval and submission of manuscript. Didier Tch\u00e9tch\u00e9 has received consultancy fees from Medtronic Plc. Quentin Cormerais, Camille Dutot and Fanny Wilquin-Bequet have been employed by Medtronic Plc. Quentin Cormerais is currently employed by MSD France at the time of final approval and submission of manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}