Learning effect and diffusion of innovative medical devices: the case of transcatheter aortic valve implantation in Italy.

Aim: We investigated the diffusion of transcatheter aortic valve implantation (TAVI) since its introduction into the Italian market aimed at identifying the potential drivers of uptake and diffusion at hospital and regional levels. Materials & methods: We estimated the determinants of TAVI diffusion in Italy from 2007 to 2015 with a regression analysis based on registry data. Results: Since 2007, TAVI has shown significant diffusion rates in Italy. The diffusion is positively correlated with implanting centers' experience and with the presence of key opinion leaders. Regional recommendations on the use of TAVI negatively influence the diffusion. Reimbursement policies do not exert a relevant impact. Conclusion: Learning effect seems to be the major driver of TAVI diffusion in Italy.