The cost-effectiveness of B-type natriuretic peptide-guided care in compared to standard clinical assessment in outpatients with heart failure in Tehran, Iran

Cost Effectiveness and Resource Allocation

Marjan Hajahmadi¹  Abdosaleh Jafari²  Aziz Rezapour³  Vahid Alipour³  Andrew J. Palmer⁴ 

[1] Cardiologist, Fellowship in Heart Failure and Cardiac Transplantation, Cardiovascular Department, Rasoul Akram General Hospital, Iran University of Medical Sciences, Tehran, Iran;Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran;Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran;Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran;Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia;

关键词: Cost-effectiveness;    Heart failure;    B-type natriuretic peptide;    Markov model;   

DOI  :  10.1186/s12962-021-00334-z

来源: Springer

【 摘 要 】

BackgroundB-type natriuretic peptide (BNP) is commonly used as a diagnostic method for patients with heart failure. This study was designed to evaluate the cost-effectiveness of BNP compared to standard clinical assessment in outpatients with heart failure with reduced ejection fraction (HFrEF) in Tehran, Iran.MethodsThis study was a cost-effectiveness analysis carried on 400 HFrEF outpatients > 45 years who were admitted to Rasoul Akram General Hospital of Tehran, Iran. A Markov model with a lifetime horizon was developed to evaluate economic and clinical outcomes for BNP and standard clinical assessment. Quality-adjusted life-years (QALYs), direct, and indirect costs collected from the patients.ResultsThe results of this study indicated that mean QALYs and cost were estimated to be 2.18 QALYs and $1835 for BNP and 2.07 and $2376 for standard clinical assessment, respectively. In terms of reducing costs and increasing QALYs, BNP was dominant compared to standard clinical assessment. Also, BNP had an 85% probability of being cost-effective versus standard clinical assessment if the willingness to pay threshold is higher than $20,800/QALY gained.ConclusionBased on the results of the present study, measuring BNP levels represents good value for money, decreasing costs and increasing QALYs compared to standard clinical assessment. It is suggested that the costs of the BNP test be covered by insurance in Iran. The result of the current study has important implications for policymakers in developing clinical guidelines for the diagnosis of heart failure.

【 授权许可】

CC BY