A Cost-Minimization and Budget Impact Analysis of NT-proBNP Screening for Systematic Sclerosis-Related Pulmonary Arterial Hypertension in an Australian Healthcare Setting
Author(s)
George Papadopoulos, BSc (Hons)1, Parinita Barman, MPH2, Amit Gupta, MSc2, Hemant Rathi, MSc2.
1Lucid Health Consulting, Sydney, Australia, 2Skyward Analytics, Gurugram, India.
1Lucid Health Consulting, Sydney, Australia, 2Skyward Analytics, Gurugram, India.
OBJECTIVES: N-terminal pro B-type natriuretic peptide (NT-proBNP) is a non-invasive test utilised in screening for systemic sclerosis-related pulmonary arterial hypertension (SSc-PAH). Clinical evidence from literature reports comparable or superior sensitivity of NT-proBNP assays compared to transthoracic echocardiogram (TTE)-based approach. This study evaluates the financial implications of introducing NT-proBNP testing for PAH screening in patients with established SSc from the Australian healthcare perspective.
METHODS: The cost minimisation analysis estimates the yearly cost of screening per patient. A budget impact analysis using epidemiological approach to estimate the number of SSc patients undergoing PAH screening was conducted over a 6-year time horizon. A reference scenario with all patients undergoing TTE alone was compared to an alternative scenario in which all patients undergo NT-proBNP testing, with a confirmatory TTE test in 10% of patients testing positive on NT-proBNP. Model inputs were sourced from Australian public databases and published literature, with costs adjusted to 2025 Australian dollars.
RESULTS: The unit cost of NT-proBNP test and TTE test was $58.50 and $258.70, respectively. The annual cost per patient associated with TTE-based approach was $284.57 compared to $90.22 with NT-proBNP, leading to yearly cost savings of $194.35 per patient. Based on an estimated prevalence of 20 cases per 100,000 population, the projected number of patients with SSc in Australia was 5,594 in Year 1, increasing to 5,859 in Year 6. Assuming 90% uptake rate of NT-proBNP test and 1.1 tests per patient/year, the estimated number of tests was 5,538 in Year 1, increasing to 5,800 in Year 6. The resulting net financial savings to the MBS was $720,890 in Year 1, increasing to $755,028 by Year 6. The model results were robust across all scenarios and sensitivity analyses conducted.
CONCLUSIONS: Over six years, NT-proBNP screening for SSc-PAH may lead to a saving of $4.4 million to the Australian public health system.
METHODS: The cost minimisation analysis estimates the yearly cost of screening per patient. A budget impact analysis using epidemiological approach to estimate the number of SSc patients undergoing PAH screening was conducted over a 6-year time horizon. A reference scenario with all patients undergoing TTE alone was compared to an alternative scenario in which all patients undergo NT-proBNP testing, with a confirmatory TTE test in 10% of patients testing positive on NT-proBNP. Model inputs were sourced from Australian public databases and published literature, with costs adjusted to 2025 Australian dollars.
RESULTS: The unit cost of NT-proBNP test and TTE test was $58.50 and $258.70, respectively. The annual cost per patient associated with TTE-based approach was $284.57 compared to $90.22 with NT-proBNP, leading to yearly cost savings of $194.35 per patient. Based on an estimated prevalence of 20 cases per 100,000 population, the projected number of patients with SSc in Australia was 5,594 in Year 1, increasing to 5,859 in Year 6. Assuming 90% uptake rate of NT-proBNP test and 1.1 tests per patient/year, the estimated number of tests was 5,538 in Year 1, increasing to 5,800 in Year 6. The resulting net financial savings to the MBS was $720,890 in Year 1, increasing to $755,028 by Year 6. The model results were robust across all scenarios and sensitivity analyses conducted.
CONCLUSIONS: Over six years, NT-proBNP screening for SSc-PAH may lead to a saving of $4.4 million to the Australian public health system.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE14
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)