Aims: Heart failure (HF) nurse practitioners (NPs) are an important part of the HF specialist team, and their impact on the cost-effectiveness of their role is unknown. The aim of this study was to determine the cost-effectiveness of a HF NP inpatient service compared with current practice of no HF NP service from a health system perspective at 12 months and 3 years.
Methods and results: We developed a Markov model to estimate costs, effects, and cost-effectiveness for hospitalized HF patients and seen by a HF NP service compared with usual care at 12 months and 3 years. Costs and effects were taken from a retrospective observational cohort study. Transition probabilities and utilities were derived from published studies. A total of 500 patients were included (250 patients in the HF NP service vs. 250 patients in usual care). Average age was 77.7 ± 11 years, and 54% were male. At 12 months, the HF NP group was cheaper and more effective compared with no HF NP [$23 031 vs. $25 111 (AUD), respectively; quality-adjusted life years (QALYs) were 0.68 in HF NP group compared with 0.66 in usual care]. The incremental cost-effectiveness ratio showed a savings of $109 474 per QALY gained at 12 months and a savings of $270 667 per QALY gained at 3 years in favour of the HF NP service.
Conclusion: The HF NP service was cost-effective with lower costs and higher QALYs compared with no HF NP service. Economic evaluations alongside randomized controlled trials are warranted.
Keywords: Cost-effectiveness; Economic evaluation; Heart failure; Nurse practitioner.
© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.