{"id":"2bb5602a5665","type":"article","url":"https://hartvaat.nl/2026/12/01/tavr-is-goedkoper-dan-savr-bij-ernstige-aortaklepstenose-kostenanalyse-in-commer/","title":"TAVR is goedkoper dan SAVR bij ernstige aortaklepstenose — kostenanalyse in commerciële verzekering","title_en":"Comparison of 1-year costs of commercially insured patients with severe aortic stenosis undergoing surgical vs. transcatheter aortic valve replacement.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","internist"],"tags":[],"journal":"Journal of medical economics","doi":"10.1080/13696998.2026.2752763","source_url":"https://doi.org/10.1080/13696998.2026.2752763","authors":["Suzanne J Baron","Benjamin Z Galper","Marcella A Kelley","Soumya G Chikermane","Shannon M E Murphy"],"significance":4,"published":"2026-11-07","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/kleplijden/aortastenose/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"This retrospective claims analysis of 3,623 US patients with severe aortic stenosis compared 1-year costs of TAVR versus surgical aortic valve replacement (SAVR). TAVR was significantly less expensive during the index hospitalization across all frailty strata (cost difference $39,000–$42,000, p<0.01) and yielded lower cumulative 1-year costs in patients with low and intermediate frailty. For clinical decision-making, the findings highlight that cost advantages of TAVR are heavily influenced by baseline patient frailty and whether concomitant cardiac procedures are performed.","created":"2026-11-01T02:02:29Z","updated":"2026-11-01T02:02:29Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze retrospectieve claimsanalyse onder 3.623 Amerikaanse patiënten met ernstige aortaklepstenose vergeleek de kosten van TAVR versus chirurgische klepvervanging (SAVR) over één jaar. TAVR was over alle kwetsbaarheidsstrata heen significant goedkoper tijdens de initiële opname (kostenverschil $39.000–$42.000, p<0,01) en had over het eerste jaar lagere totale kosten bij patiënten met lage en matige kwetsbaarheid. Voor de klinische besluitvorming benadrukt het onderzoek dat de economische voordelen van TAVR sterk afhangen van de basale kwetsbaarheid en of er alleen de klep of ook andere hartoperaties worden uitgevoerd.","abstract_original":"BACKGROUND: Patients with aortic stenosis (AS) have been shown to have lower costs at 1 year with transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (SAVR) in a Medicare population. The difference in costs between TAVR and SAVR in commercially insured patients with AS in the United States is unknown. METHODS: Using the Optum claims database, AS patients receiving either TAVR or SAVR between 3/2019 and 9/2022 were identified. Patients were categorized into low, intermediate or high strata using the Hospital Frailty Risk Score (HFRS). The primary outcome was total 1-year cost, defined as the sum of index AVR hospitalization and 1-year follow-up costs. Risk-adjusted generalized linear models were used to assess the difference in the costs between TAVR and SAVR. RESULTS: 3,623 patients (952 TAVR; 2,671 SAVR) were identified. TAVR patients had lower index hospitalization costs compared with SAVR patients across all HFRS strata (cost difference for low: $39,312, p < 0.01; intermediate: $42,006, p < 0.01; high: $39,431, p = 0.03). Cumulative costs through one year were significantly lower with TAVR in the low and intermediate HFRS strata (cost difference for low: $32,116, p < 0.01; intermediate $40,905, p < 0.01) and numerically lower in the high HFRS stratum (cost difference: $35,881, p = 0.15). When the analysis was restricted to isolated AVR, the 1-year difference was no longer significant in the low and intermediate HFRS strata ($8,064 and $11,314, respectively) and was numerically reversed in the high HFRS stratum (-$28,804). CONCLUSIONS: In a commercial payor population of real-world patients with AS, TAVR was associated with lower standardized index hospitalization costs across all HFRS strata and lower standardized 1-year costs in the low and intermediate HFRS strata. These findings demonstrate that baseline frailty and procedural scope are critical determinants of short and intermediate-term cost differences between TAVR and SAVR for the treatment of AS in commercial populations."}