Early TAVR for patients with asymptomatic severe AS may save money in the long run
When patients in Europe present with asymptomatic severe aortic stenosis (aSAS), performing transcatheter aortic valve replacement (TAVR) early instead of waiting for symptoms to develop may result in better quality-of-life outcomes and considerable cost savings. That’s according to a new study published in European Heart Journal Open.[1]
Researchers performed a cost-utility analysis that covered nine different European countries: Belgium, France, Germany, Italy, the Netherlands, Spain, Sweden, Switzerland and the United Kingdom. They used data from the EARLY TAVR trial, which tracked 901 patients with aSAS who were randomized to either undergo TAVR or a strategy of clinical surveillance (CS), to perform this analysis.
“Whether a strategy of early intervention with TAVR compared to CS is cost-effective among patients with severe AS and no symptoms has never been studied,” wrote first author Philippe Généreux, MD, an interventional cardiologist and director of the structural heart program at Morristown Medical Center’s Gagnon Cardiovascular Institute, and colleagues.
Overall, Généreux et al. found that early TAVR was linked to lower lifetime healthcare costs and more quality-adjusted life years per person than CS. This was true for all nine countries. Early TAVR was associated with higher costs initially, the group added, but the CS patients were more likely to be hospitalized for heart failure or experience a stroke; this shows how waiting for care can actually lead to patients requiring more care in the long run.
“These findings are robust, with results from probabilistic sensitivity analyses indicating >97% probability of cost-effectiveness for all countries,” the authors wrote. “Consistent findings were observed across a variety of scenario analyses.”
Généreux and colleagues concluded that these findings support policies that expand patient access to early TAVR.
This study and EARLY TAVR were both funded by Edwards Lifesciences, the company behind the Sapien 3 platform. Edwards Lifesciences has been asking the U.S. Centers of Medicare and Medicaid Services to approve asymptomatic TAVR since 2025.
Click here to read the team’s full analysis in European Heart Journal Open.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.