Ruling out cardiac failure: cost-benefit analysis of a sequential testing strategy with NT-proBNP before echocardiography

Ups J Med Sci. 2013 May;118(2):75-9. doi: 10.3109/03009734.2012.751471. Epub 2012 Dec 12.


Objectives: 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.

Conclusion: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cost-Benefit Analysis*
  • Echocardiography*
  • Heart Failure / diagnosis*
  • Heart Failure / diagnostic imaging
  • Humans
  • Middle Aged
  • Natriuretic Peptide, Brain / metabolism*
  • Retrospective Studies


  • Natriuretic Peptide, Brain