Reinhold Thomas, Berghöfer Anne, Willich Stefan N
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin.
Herz. 2010 Jan;35(1):1-10. doi: 10.1007/s00059-010-3312-8.
Heart failure is an important cardiac disease with an increasing prevalence in Western societies. In addition to a significant reduction of the patient's physical capability and quality of life, cardiac insufficiency is associated with considerable expenditure by national health care systems. A number of imaging techniques are available for the detection of heart failure (e.g., echocardiography), and the use of biomarkers such as brain natriuretic peptides (BNP or NT-proBNP) becomes increasingly popular in the process of screening and diagnosis. Until now, there is a lack of information regarding health-economic aspects of this biomarker use. For this reason, a systematic literature search was conducted in MEDLINE including all relevant studies published up to and including August 2009. The primary objective was to summarize the main findings of all relevant investigations which focus on health-economic aspects of BNP use as well as NT-proBNP use. Out of 64 initial search results, 13 relevant studies were identified which met the inclusion criteria. Eleven studies were finally included in this literature review. Although the methodology of these studies was very heterogeneous, the majority of investigations indicate that the use of BNP and NT-proBNP, respectively, is a cost-effective procedure for heart failure diagnosis and prognosis, as well as for heart failure screening. However, keeping in mind that the transferability of economics study results is limited due to a number of differences between national health care systems, there are no investigations with a focus on the financial implications for Germany. Further research is required in this context.
心力衰竭是一种重要的心脏疾病，在西方社会的患病率呈上升趋势。除了患者身体能力和生活质量大幅下降外，心脏功能不全还给国家医疗保健系统带来了可观的支出。有多种成像技术可用于检测心力衰竭（如超声心动图），并且在筛查和诊断过程中，使用生物标志物如脑钠肽（BNP或NT-proBNP）越来越普遍。到目前为止，关于使用这种生物标志物的卫生经济方面的信息还很缺乏。因此，我们在MEDLINE中进行了系统的文献检索，纳入了截至2009年8月（包括8月）发表的所有相关研究。主要目的是总结所有相关调查的主要结果，这些调查聚焦于BNP和NT-proBNP使用的卫生经济方面。在64个初始检索结果中，确定了13项符合纳入标准的相关研究。最终有11项研究被纳入本综述。尽管这些研究的方法非常不同，但大多数调查表明，分别使用BNP和NT-proBNP对于心力衰竭的诊断、预后以及心力衰竭筛查是一种具有成本效益的方法。然而，鉴于各国医疗保健系统之间存在诸多差异，经济研究结果的可转移性有限，目前尚无针对德国财务影响的研究。在此背景下需要进一步研究。
