Economic evaluation of NT-proBNP testing plus standard clinical assessment versus standard clinical assessment alone for the prevention of heart failure in older adults with type 2 diabetes.

Figures

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  Figure 1. HF model structure. Note: Cost accruals for state transitions included risk assessment costs (NT-proBNP testing, standard clinical assessments, echocardiograms, and cardiologist visits for echocardiograms), annual costs for diabetes treatment in individuals without HF, costs for HF hospitalization events, and annual costs for treating chronic or advanced HF. aIndividuals identified as at high risk for HF hospitalization who have their risk confirmed by echocardiography are placed on ICP treatment. In the model, these individuals transition to the No event, ICP treatment health state, where their risk of HF hospitalization and death is reduced due to appropriate treatment. bIndividuals at high risk for HF hospitalization but with a test result that denoted NT-proBNP ≤125 pg/mL do not undergo echocardiographic confirmation and are inappropriately categorized as low risk. They remain on limited cardioprotective treatment and are therefore undertreated, resulting in a higher risk of HF hospitalization and death. cIndividuals at low risk for HF hospitalization but with a test result denoting NT-proBNP >125 pg/mL undergo an unnecessary echocardiogram and remain on LCP treatment.…

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  Figure 2. (A) LYs and QALYs, (B) average number of hospitalizations, and (C) lifetime medical costs accrued by adults ≥65 years receiving NT-proBNP plus standard clinical assessment and standard clinical assessment alone. (D) Scatter plot showing the incremental costs and incremental QALYs for adults ≥65 years across 10 000 simulations. ICER, incremental cost-effectiveness ratio; LY, life year; NT-proBNP, N-terminal pro-B-type natriuretic peptide; QALY, quality-adjusted life-year; WTP, willingness-to-pay.

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  Figure 3. One-way sensitivity analysis results: base-case analysis. Note: For each parameter, the label lists the base-case value followed by the minimum and maximum values used in the one-way sensitivity analysis. HF, heart failure; ICER, incremental cost-effectiveness ratio; NT-proBNP, N-terminal pro-B-type natriuretic peptide; SGLT2i, sodium-glucose cotransporter-2 inhibitor.