title: Ruling out cardiac failure: cost-benefit analysis of a sequential testing strategy with NT-proBNP before echocardiography.
abstract: OBJECTIVE
  To estimate the possible economic benefit of a sequential testing strategy with NT-proBNP to reduce the number of echocardiographies.
  
  
  METHODS
  Retrospective study in a third-party payer perspective. The costs were calculated from three Swedish counties: Blekinge, Östergötland, and Uppland. Two cut-off levels of NT-proBNP were used: 400 and 300 pg/mL. The cost-effectiveness of the testing strategy was estimated through the short-term cost avoidance and reduction in demand for echocardiographies.
  
  
  RESULTS
  The estimated costs for NT-proBNP tests and echocardiographies per county were reduced by 33%-36% with the 400 pg/mL cut-off and by 28%-29% with the 300 pg/mL cut-off. This corresponded to a yearly cost reduction of approximately €2-5 million per million inhabitants in these counties.
  
  
  CONCLUSIONS
  The use of NT-proBNP as a screening test could substantially reduce the number of echocardiographies in the diagnostic work-up of patients with suspected cardiac failure, as well as the associated costs.
authors.affiliation: Department of Clinical Chemistry, Blekinge County Hospital, Karlskrona, Sweden. mjferrandis@gmail.com
authors.forename: Maria-José
authors.initials: MJ
authors.lastname: Ferrandis
authors.forename: Ingvar
authors.initials: I
authors.lastname: Ryden
authors.forename: Tomas L
authors.initials: TL
authors.lastname: Lindahl
authors.forename: Anders
authors.initials: A
authors.lastname: Larsson
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D004452:Echocardiography; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D020097:Natriuretic Peptide, Brain