Presentation (CTI)

OBJECTIVES: Economic evaluation models inform decision-making regarding heart failure (HF) management. This review aimed to identify, synthesize and appraise cost-effectiveness analyses on non-pharmacologic HF management approaches.
METHODS: Database search was conducted in MEDLINE, Embase, Web of Science, the Cochrane Library and Google Scholar for studies published up to February 2026. Eligible studies were full cost-effectiveness analyses (CEAs) that compared the costs and outcomes of non-pharmacologic HF management approaches. Reporting quality was assessed using the Consensus Health Economic Criteria (CHEC) checklist.
RESULTS: A total of 48 studies were included and 75 CEA results were disaggregated. Decision-analytic models using Markov model were frequently applied. Interventions were biomarker-guided therapy, telehealth, multidisciplinary care programs and other emerging approaches. Most studies were cost-effective compared with standard-of-care (SOC). Telehealth approaches were dominantly studied CEAs. Multidisciplinary programs were cost-effective in all studies. Biomarker-guided approaches reported the lowest cost per quality-adjusted-life-years (QALYs). Evidence for emerging approaches were limited, low quality data inputs and they relied on oversimplistic assumptions. Main drivers of outcomes were HF management implementation contexts, data sources and model assumptions. Assessment of studies showed good quality of reporting using CHEC.
CONCLUSIONS: Altogether, non-pharmacologic HF management approaches were widely cost-effective compared to standard-of-care. However, findings exhibited heterogeneities in modelling, implementation contexts and data sources. Therefore, future designs of Economic Evaluations (EEs) should prioritise incorporation of real-world evidence, transparent modelling approaches and inclusion of diverse populations to improve decision relevance across healthcare settings.