A Cost-Minimization and Budget Impact Analysis of NT-proBNP Screening Test for Risk Assessment and Monitoring of Pulmonary Arterial Hypertension (PAH) Patients in 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 potential biomarker for risk stratification in patients with diagnosed pulmonary arterial hypertension (PAH). The evidence from literature comparing the prognostic performance of NT-proBNP versus transthoracic echocardiogram (TTE) revealed similar prognostic performance for both diagnostic procedures. This study compares the financial implication of introducing NT-proBNP biomarker assay with TTE-based approach in patients with PAH undergoing regular risk-assessment from the Australian healthcare perspective.
METHODS: The cost minimisation analysis estimates the yearly cost of screening per patient. A budget impact analysis was conducted over a 6-year time horizon using an epidemiological approach to estimate the number of PAH patients undergoing NT-proBNP testing (four tests per patient annually). The model compared a reference scenario with TTE alone to an alternative scenario with NT-proBNP and TTE test, where NT-proBNP was 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. Scenario and sensitivity analyses were performed to assess uncertainty in model inputs.
RESULTS: The unit costs for NT-proBNP test fee and TTE were $58.50, and $258.70, respectively. Over 1-year time horizon, the total cost per patient associated with TTE-based approach was $1,034.80 compared to $880.75 associated with NT-proBNP, leading to yearly cost-saving of $154.05. The budget impact model estimated 2,450 diagnosed PAH patients in Year 1 increasing to 3,619 by Year 6. Assuming a 90% uptake rate of NT-proBNP testing, the net financial savings to Medicare Benefits Schedule (MBS) was $284,338 in Year 1, increasing to $429,375 in Year 6 (85% MBS rebate applied). All scenario and sensitivity analyses demonstrated that NT-proBNP test was either cost-saving or cost-neutral.
CONCLUSIONS: Routine use of NT-proBNP test for risk assessment and monitoring in PAH could result in considerable costs savings of $2.3M over six years.
METHODS: The cost minimisation analysis estimates the yearly cost of screening per patient. A budget impact analysis was conducted over a 6-year time horizon using an epidemiological approach to estimate the number of PAH patients undergoing NT-proBNP testing (four tests per patient annually). The model compared a reference scenario with TTE alone to an alternative scenario with NT-proBNP and TTE test, where NT-proBNP was 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. Scenario and sensitivity analyses were performed to assess uncertainty in model inputs.
RESULTS: The unit costs for NT-proBNP test fee and TTE were $58.50, and $258.70, respectively. Over 1-year time horizon, the total cost per patient associated with TTE-based approach was $1,034.80 compared to $880.75 associated with NT-proBNP, leading to yearly cost-saving of $154.05. The budget impact model estimated 2,450 diagnosed PAH patients in Year 1 increasing to 3,619 by Year 6. Assuming a 90% uptake rate of NT-proBNP testing, the net financial savings to Medicare Benefits Schedule (MBS) was $284,338 in Year 1, increasing to $429,375 in Year 6 (85% MBS rebate applied). All scenario and sensitivity analyses demonstrated that NT-proBNP test was either cost-saving or cost-neutral.
CONCLUSIONS: Routine use of NT-proBNP test for risk assessment and monitoring in PAH could result in considerable costs savings of $2.3M over six years.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE15
Topic
Economic Evaluation, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), No Additional Disease & Conditions/Specialized Treatment Areas