Cost comparison between transcatheter aortic valve implantation and surgical valve replacement using individual data in a Spanish public hospital

Abstract

BackgroundTranscatheter aortic valve implantation has revolutionized the management of aortic stenosis and is currently an alternative to surgical aortic valve replacement. Some studies have found costs of percutaneous procedure to be greater than those of surgical replacement. However, these published studies are based on pooled data from clinical registries. The objective of the present study was to compare costs of both treatments during the hospital phase in a Spanish public hospital. MethodsA hospital phase cost study consisted of patients diagnosed and treated with aortic stenosis in a Spanish tertiary hospital between 1st January 2019 and 29th February 2020. An individual analysis was conducted in relation to real costs pertaining to materials, staffing and hospital stay. Several baseline characteristics were controlled for. ResultsMean costs per patient from procedure through to discharge were 26,684.1 € in the percutaneous group and 14,939.5 € in the surgical group (p<0.001). Independent of comorbidities, the cost of transcatheter aortic valve implantation was, on average, 8636.6 € greater than that of surgical aortic valve replacement (95% CI 6086.3–11,186.9; p < 0.001). ConclusionsAortic stenosis treatment costs in hospital phase were greater when percutaneous option was used in comparison to surgery.