Peer-Reviewed Journal Details
Mandatory Fields
Ledwidge, MT,O'Connell, E,Gallagher, J,Tilson, L,James, S,Voon, V,Bermingham, M,Tallon, E,Watson, C,O'Hanlon, R,Barry, M,McDonald, K
2015
July
European Journal of Heart Failure
Cost-effectiveness of natriuretic peptide-based screening and collaborative care: a report from the STOP-HF (St Vincent's Screening TO Prevent Heart Failure) study
Validated
Optional Fields
Natriuretic peptide screening Cost-effectiveness Left ventricular dysfunction Heart failure Primary care Cardiovascular prevention CARDIOVASCULAR RISK CARDIAC EVENTS DISEASE DYSFUNCTION POPULATION GUIDELINES MANAGEMENT PROJECT TRIAL
17
672
679
AimsPrevention of cardiovascular disease and heart failure (HF) in a cost-effective manner is a public health goal. This work aims to assess the cost-effectiveness of the St Vincent's Screening TO Prevent Heart Failure (STOP-HF) intervention.Methods and resultsThis is a substudy of 1054 participants with cardiovascular risk factors [median age 65.8years, interquartile range (IQR) 57.8:72.4, with 4.3years, IQR 3.4:5.2, follow-up]. Annual natriuretic peptide-based screening was performed, with collaborative cardiovascular care between specialist physicians and general practitioners provided to patients with BNP levels >50pg/mL. Analysis of cost per case prevented and cost-effectiveness per quality-adjusted life year (QALY) gained was performed. The primary clinical endpoint of LV dysfunction (LVD) with or without HF was reduced in intervention patients [odds ratio (OR) 0.60; 95% confidence interval (CI) 0.38-0.94; P = 0.026]. There were 157 deaths and/or emergency hospitalizations for major adverse cardiac events (MACE) in the control group vs. 102 in the intervention group (OR 0.68; 95% CI 0.49-0.93; P = 0.01). The cost per case of LVD/HF prevented was Euro9683 (sensitivity range -Euro843 to Euro20 210), whereas the cost per MACE prevented was Euro3471 (sensitivity range -Euro302 to Euro7245). Cardiovascular hospitalization savings offset increased outpatient and primary care costs. The cost per QALY gain was Euro1104 and the intervention has an 88% probability of being cost-effective at a willingness to pay threshold of Euro30 000.ConclusionAmong patients with cardiovascular risk factors, natriuretic peptide-based screening and collaborative care reduced LVD, HF, and MACE, and has a high probability of being cost-effective.Trial registrationNCT00921960
10.1002/ejhf.286
Grant Details