A digital diagnostic pathway for heart failure: an economic evaluation

Guidelines recommend prompt diagnosis of suspected heart failure in people with elevated N-terminal pro b-type natriuretic peptide (NT-proBNP). Early diagnosis of heart failure improves patient outcomes, however diagnosis is complex and can often be delayed. Digital platforms can provide clinicians with greater access to information with which to diagnose heart failure, improving on standard diagnostic pathways. We modelled the potential cost-effectiveness of a digital pathway, adapting the UK NICE guideline (NG106) cost-effectiveness model to evaluate the impact of potentially speedier diagnosis and treatment of heart failure. Posited reductions in time to treatment were modelled to reduce short-term mortality and generate approximately 0.056 incremental quality adjusted life-years over a lifetime horizon. Additional costs arose from earlier heart failure treatment, resulting in a cost per quality adjusted life-year of £5,882 (95% confidence interval £4,377 - £11,084).