Why the study?
Published evidence supports NT-proBNP alongside TTE for multiparameter risk stratification in PAH, motivating a comparison of the financial implications of a publicly funded NT-proBNP biomarker assay versus a TTE-based approach from the Australian healthcare perspective.
Does publicly funded NT-proBNP-guided risk assessment reduce annual per-patient healthcare costs and 6-year budget impact compared to a TTE-only approach in patients with pulmonary arterial hypertension?
Does publicly funded NT-proBNP-guided risk assessment reduce annual per-patient healthcare costs and 6-year budget impact compared to a TTE-only approach in patients with pulmonary arterial hypertension?
Implementing routine publicly funded NT-proBNP testing alongside echocardiography for pulmonary arterial hypertension risk monitoring in Australia is projected to save $154.05 per patient annually and $2.3 million over 6 years.
Answers are grounded in this paper and cite their sources.
Supports modeled PAH monitoring efficiencies; leaves open prospective validation before practice adoption.
OBJECTIVES: N-terminal pro B-type natriuretic peptide (NT-proBNP) is a biomarker for risk stratification in patients with pulmonary arterial hypertension (PAH). Published evidence supports NT-proBNP as a complementary parameter within the multiparameter risk stratification framework recommended by the 2022 European Society of Cardiology/European Respiratory Society guidelines, used alongside transthoracic echocardiography (TTE). This study compares the financial implications of a publicly funded NT-proBNP biomarker assay with a TTE-based approach in patients with PAH from the Australian healthcare perspective. METHODS: The cost-minimization analysis estimates the annual per-patient cost of risk assessment in PAH. Additionally, a 6-year budget-impact analysis was conducted using an epidemiological approach. The model compared publicly funded NT-proBNP-guided risk assessment in PAH with a reference scenario using TTE alone, with NT-proBNP estimated to replace 1.5 TTE tests per patient annually. Model inputs were derived from Australian public databases and published literature, with costs adjusted to 2025 Australian dollars. RESULTS: The unit costs for NT-proBNP and TTE tests were $58.50 and $258.70, respectively. The annual per-patient cost with public funding of NT-proBNP was $880.75 compared with $1034.80 without NT-proBNP, leading to a yearly cost saving of $154.05. The budget-impact model estimated 2450 patients with PAH in year 1, increasing to 3619 by year 6. Assuming 90% uptake rate of NT-proBNP testing, the net savings to the Medicare Benefits Schedule ranged from $288 549 in year 1 to $426 190 in year 6 (85% Medicare Benefits Schedule rebate applied). CONCLUSIONS: Routine NT-proBNP testing for risk assessment and monitoring in PAH could result in considerable cost savings of $2.3 million over 6 years.
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Papadopoulos et al. (2026) studied Pulmonary arterial hypertension. Publicly funded NT-proBNP-guided risk assessment vs. Transthoracic echocardiography (TTE)-based approach alone was evaluated on Annual per-patient cost of risk assessment in pulmonary arterial hypertension (2025 Australian dollars) (Annual per-patient cost saving $154.05; 6-year net budget savings $2.3 million).
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