An annual discount rate of 3% was applied to both costs and benefits. Costs related to the procedure, hospitalization, complications, and follow-up were included (euros in 2019). Effectiveness parameters were based on the PARTNER trials. We conducted a cost-effectiveness analysis of SAPIEN 3 vs SAVR/CMT, using a Markov model (monthly cycles) with 8 states defined by the New York Heart Association and a time horizon of 15 years, including major complications and management after hospital discharge, from the perspective of the National Health System. Our aim was to evaluate the efficiency of SAPIEN 3 vs conservative medical treatment (CMT) or surgical aortic valve replacement (SAVR) in symptomatic inoperable patients at high or intermediate risk. Its indications have recently been expanded to include patients at intermediate and low surgical risk. Transcatheter aortic valve implant has become a widely accepted treatment for inoperable patients with aortic stenosis and patients at high surgical risk.
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