Key result
NT-proBNP screening to guide cardioprotective therapy saves ~$6558 per QALY vs standard care in diabetes.
Why the study?
Heart failure is a costly, prevalent complication of T2D, motivating an evaluation of the cost-effectiveness of NT-proBNP-guided cardiovascular risk stratification to guide cardioprotective treatment.
Does NT-proBNP-guided cardiovascular screening improve cost-effectiveness and QALYs compared to standard of care in Chinese adults with Type 2 Diabetes?
Does NT-proBNP-guided cardiovascular screening improve cost-effectiveness and QALYs compared to standard of care in Chinese adults with Type 2 Diabetes?
NT-proBNP-guided screening to prioritize cardioprotective treatment in Chinese patients with type 2 diabetes is cost-effective and potentially cost-saving.
Answers are grounded in this paper and cite their sources.
NT-proBNP screening at 400 pg/mL may be cost-saving in Chinese type 2 diabetes; hypothesis-generating pending randomized confirmation.
Aims Heart failure (HF) is among the most costly and prevalent complications of type 2 diabetes (T2D), with annual incremental healthcare costs reaching US$12800 in Hong Kong. We evaluated the cost‐effectiveness of NT‐proBNP‐guided cardiovascular risk stratification to guide cardioprotective treatment. Materials and Methods We developed a four‐state Markov cohort model with transition probabilities estimated from the Hong Kong Diabetes Biobank (2014–2019). Patients were classified as low or high risk of HF based on NT‐proBNP cut‐offs of 400 and 125 pg/mL. The analysis was conducted from a payer's perspective over a lifetime horizon, utilising annual cycles and 2023 costs. Outcomes included incremental cost‐effectiveness ratios (ICERs), life years (LY) and quality‐adjusted life years (QALY), with a willingness‐to‐pay (WTP) threshold of USD 50889 to USD 152667 (1–3 × Hong Kong GDP per capita). Results NT‐proBNP screening utilising 400 pg/mL was cost‐saving (ICER: −USD $6558 per QALY) versus standard of care, yielding lower costs (−USD $846) and higher QALYs (0.129). The 125 pg/mL cut‐off was cost‐effective (ICER: USD $29 290 per QALY). Deterministic sensitivity analysis showed NT‐proBNP specificity as the key driver of ICERs in both cut‐offs. Probability Sensitivity Analysis results revealed a 100% probability of dominance for the 400 pg/mL cut‐off and 98% for the 125 pg/mL cut‐off at Hong Kong’s willingness‐to‐pay thresholds (USD$50,889–152,667). Conclusions Using NT‐proBNP to prioritise use of cardioprotective treatment on top of standard of care to reduce the risk of progression to HF in Chinese patients with T2D is cost‐effective, supporting its integration into clinical practise.
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Li et al. (2026) studied Type 2 diabetes. NT-proBNP-guided cardiovascular screening vs. Standard of care was evaluated on Incremental cost-effectiveness ratios (ICERs) (ICER: -USD $6558 per QALY). NT-proBNP screening using a 400 pg/mL cut-off was cost-saving compared to standard of care (ICER: -USD $6558 per QALY) for guiding cardioprotective treatment in Chinese adults with type 2 diabetes.
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