ECONOMIC EVALUATION OF NT-PROBNP-SUPPORTED INTENSIVE POST-DISCHARGE HEART FAILURE CARE IN VIETNAM
Author(s)
Kaywei Low, MSc1, Prof. Pham Manh Hung, PhD, MD2, Prof. Truong Quang Binh, MD, PhD3, Assoc. Prof. Nguyen Thi Thu Hoai, MD, PhD4, Dr. Vu Quynh Nga, MD, PhD5, Dr. Vu Hoang Vu, MD, PhD3.
1Roche Diagnostics Asia Pacific, Singapore, Singapore, 2Vietnam National Heart Association, Hanoi, Viet Nam, 3University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam, 4Vietnam National Heart Institute Bach Mai Hospital, Hanoi, Viet Nam, 5Hanoi Heart Hospital, Hanoi, Viet Nam.
1Roche Diagnostics Asia Pacific, Singapore, Singapore, 2Vietnam National Heart Association, Hanoi, Viet Nam, 3University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam, 4Vietnam National Heart Institute Bach Mai Hospital, Hanoi, Viet Nam, 5Hanoi Heart Hospital, Hanoi, Viet Nam.
OBJECTIVES: Heart failure (HF) presents a critical public health challenge in Vietnam, accounting for 15% of all hospital admissions. Vulnerability is highest early post-discharge, with 24.3% of patients experiencing readmission or death within 30-days due to suboptimal follow-up and under-titrated guideline-directed medical therapy (GDMT). The STRONG-HF trial demonstrated that high-intensity post-discharge care utilizing serial NT-proBNP monitoring to guide rapid GDMT up-titration significantly reduces 180-day readmissions or mortality. This approach, endorsed by the 2024 Vietnam National Heart Association guidelines, offers a transformative opportunity to optimize local HF outcomes. Accordingly, this study evaluates its economic impact, quantifying the extent to which upfront NT-proBNP testing and accelerated titration costs are offset by reductions in costly downstream clinical events.
METHODS: A 180-day cost analysis was conducted from the Vietnamese public payer perspective, comparing NT-proBNP-supported high-intensity care (HIC) with usual care (UC). The model was informed by STRONG-HF and locally adapted through consultation with Vietnamese clinicians. HIC included four follow-up visits with clinical review, laboratory testing, and serial NT-proBNP monitoring; UC included three follow-up visits guided by clinical assessment, patient tolerance, and standard biochemistry. Clinical outcomes and resource use were aligned with STRONG-HF, while costs were derived from local public databases and published literature. Uncertainty was evaluated via deterministic sensitivity and clinical scenario analyses.
RESULTS: Within 180 days post-discharge, HIC reduced all-cause mortality by 15.0% and decreased absolute HF readmission rates by 44.4% compared to UC. HIC reduced per-capita medical expenditure by 36.5% (saving 3.0 million VND/ person), as upfront outlays for lab testing and optimized GDMT were offset by avoided readmission costs. Sensitivity and scenario analyses confirmed HIC remained cost-saving across all plausible parameter variations.
CONCLUSIONS: NT-proBNP-supported intensive GDMT optimization improves health outcomes and offers substantial cost savings for Vietnam's public payer, supporting the integration of serial NT-proBNP testing into national post-discharge HF care protocols.
METHODS: A 180-day cost analysis was conducted from the Vietnamese public payer perspective, comparing NT-proBNP-supported high-intensity care (HIC) with usual care (UC). The model was informed by STRONG-HF and locally adapted through consultation with Vietnamese clinicians. HIC included four follow-up visits with clinical review, laboratory testing, and serial NT-proBNP monitoring; UC included three follow-up visits guided by clinical assessment, patient tolerance, and standard biochemistry. Clinical outcomes and resource use were aligned with STRONG-HF, while costs were derived from local public databases and published literature. Uncertainty was evaluated via deterministic sensitivity and clinical scenario analyses.
RESULTS: Within 180 days post-discharge, HIC reduced all-cause mortality by 15.0% and decreased absolute HF readmission rates by 44.4% compared to UC. HIC reduced per-capita medical expenditure by 36.5% (saving 3.0 million VND/ person), as upfront outlays for lab testing and optimized GDMT were offset by avoided readmission costs. Sensitivity and scenario analyses confirmed HIC remained cost-saving across all plausible parameter variations.
CONCLUSIONS: NT-proBNP-supported intensive GDMT optimization improves health outcomes and offers substantial cost savings for Vietnam's public payer, supporting the integration of serial NT-proBNP testing into national post-discharge HF care protocols.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE41
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)