Cost-effectiveness of transcatheter aortic valve implantation for asymptomatic severe aortic stenosis in the Kingdom of Saudi Arabia
5 affiliations
- 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University
- 2York Health Economics Consortium Ltd
- 3Heart Health Center, King Saud Medical City, Riyadh First Health Cluster
- 4Edwards Lifesciences
- 5Saudi Arabia Ministry of Health
Abstract
Introduction: Aortic stenosis (AS) is defined as the narrowing of the aortic valve. The benefits of implementing early aortic valve replacement (AVR), while the AS is asymptomatic, have been demonstrated in various clinical trials compared with clinical surveillance (CS) of delayed AVR upon symptom onset. The study aims to estimate the cost-effectiveness of transcatheter aortic valve implantation (TAVI) for the treatment of asymptomatic severe aortic stenosis (aSAS) in the Kingdom of Saudi Arabia (KSA).
Methods: A cost–utility analysis compared TAVI using the SAPIEN 3/SAPIEN 3 Ultra valve with CS in an aSAS population. A Markov model consisting of three health states—alive and well, stroke, and death—captured the peri-procedural and long-term outcomes across a lifetime horizon. Inputs were derived from the EARLY TAVR trial (NCT03042104) and existing literature.
Results: The model findings estimated that TAVI was cost-saving and more effective (dominant) compared with CS for people with aSAS, with a 97.3% probability of being cost-effective. Incremental results per person included an estimated cost saving of SAR 33,414, an estimated quality-adjusted life year gain of 0.17, and an estimated life-year gain of 0.12. The key driver of the model was the weighting of disabling stroke for the CS arm.
Conclusion: Early implementation of TAVI for those with aSAS is estimated to result in reduced costs and greater benefits compared with CS. These findings support the idea that timely intervention could enhance AS disease management in line with KSA policy.
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- Changes in the institutional treatment of severe aortic stenosis following the introduction of transcatheter aortic valve implantation
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BibTeX
@article{alomar2026costeffectiveness,
title = {{Cost-effectiveness of transcatheter aortic valve implantation for asymptomatic severe aortic stenosis in the Kingdom of Saudi Arabia}},
author = {Hussain Abdulrahman Al-Omar and Madison Montgomery and Heather Davies and Elana Greaves and Reagan Davis and Lucy Hillcoat and Hazim J. Rahbi and Adham Salem and Pascal Candolfi and Abdulaziz Al Rabiah},
journal = {Frontiers in Cardiovascular Medicine},
year = {2026},
month = oct,
doi = {10.3389/fcvm.2026.1937664},
url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1937664/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cost-effectiveness of transcatheter aortic valve implantation for asymptomatic severe aortic stenosis in the Kingdom of Saudi Arabia
AU - Hussain Abdulrahman Al-Omar
AU - Madison Montgomery
AU - Heather Davies
AU - Elana Greaves
AU - Reagan Davis
AU - Lucy Hillcoat
AU - Hazim J. Rahbi
AU - Adham Salem
AU - Pascal Candolfi
AU - Abdulaziz Al Rabiah
PY - 2026
DA - 2026/10/29
JO - Frontiers in Cardiovascular Medicine
DO - 10.3389/fcvm.2026.1937664
UR - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1937664/full
AB - Introduction: Aortic stenosis (AS) is defined as the narrowing of the aortic valve. The benefits of implementing early aortic valve replacement (AVR), while the AS is asymptomatic, have been demonstrated in various clinical trials compared with clinical surveillance (CS) of delayed AVR upon symptom onset. The study aims to estimate the cost-effectiveness of transcatheter aortic valve implantation (TAVI) for the treatment of asymptomatic severe aortic stenosis (aSAS) in the Kingdom of Saudi Arabia (KSA). Methods: A cost–utility analysis compared TAVI using the SAPIEN 3/SAPIEN 3 Ultra valve with CS in an aSAS population. A Markov model consisting of three health states—alive and well, stroke, and death—captured the peri-procedural and long-term outcomes across a lifetime horizon. Inputs were derived from the EARLY TAVR trial (NCT03042104) and existing literature. Results: The model findings estimated that TAVI was cost-saving and more effective (dominant) compared with CS for people with aSAS, with a 97.3% probability of being cost-effective. Incremental results per person included an estimated cost saving of SAR 33,414, an estimated quality-adjusted life year gain of 0.17, and an estimated life-year gain of 0.12. The key driver of the model was the weighting of disabling stroke for the CS arm. Conclusion: Early implementation of TAVI for those with aSAS is estimated to result in reduced costs and greater benefits compared with CS. These findings support the idea that timely intervention could enhance AS disease management in line with KSA policy.
SN - 2297-055X
ER -