Economic evaluation of NT-proBNP for heart failure risk assessment in patients with type 2 diabetes in China.

AIMS: Heart failure (HF) affects up to 40 % of patients with type 2 diabetes mellitus (T2DM), imposing significant clinical and economic burdens. N-terminal pro-B-type natriuretic peptide (NT-proBNP) effectively assesses HF risk, but its economic value in China is unclear.

METHODS

This study evaluated the cost-effectiveness of three HF risk assessment strategies in patients with T2DM: NT-proBNP-guided assessment (using a cut-off of ≥125 pg/mL), usual care in China, and Systematic COronary Risk Evaluation (SCORE). A decision tree and Markov model with 1-year cycles simulated lifetime direct medical costs (given in United States dollars [US$]) and health outcomes in patients with T2DM aged ≥40 years from a Chinese healthcare perspective. High-risk patients received SGLT2 inhibitors plus standard of care.

RESULTS

Compared with usual care, the NT-proBNP-guided strategy was cost-saving, reducing costs by US$1002.73 while increasing QALYs by 0.055 per patient. It was also less costly and more effective than the SCORE strategy. Probabilistic sensitivity analysis confirmed the robustness of this finding, demonstrating a 96.9 % probability of the NT-proBNP strategy being cost-saving versus usual care.

CONCLUSIONS

NT-proBNP is a dominant and robust cost-saving strategy for HF risk assessment in patients with T2DM in China, reducing both HF cases and associated healthcare costs.