Medicare will begin covering the NT-proBNP blood test for diagnosing heart failure starting Friday, November 1. However, patients can only undergo this test once a year.
Professor Andrew Sindone, a cardiologist who played a key role in securing this funding, noted that patients will save approximately $80, as the test was previously only covered when ordered in emergency departments. This change is particularly beneficial for those in rural and regional areas who have limited access to echocardiograms.
In 2011, the federal government denied a request for Medicare coverage due to insufficient data and cost concerns. The decision to reverse this stance involved extensive consultations with government ministers and subcommittees of the Medical Services Advisory Committee (MSAC), which ultimately approved the test a year ago. The approval was based on the premise that it would reduce unnecessary echocardiograms, leading to cost savings for the government.
Although funding was allocated in the May budget, implementation was delayed until now.
The NT-proBNP test is primarily used to rule out heart failure rather than confirm it. Elevated levels of N-terminal pro B-type natriuretic peptide indicate that the heart is under stress. A low NT-proBNP level can exclude heart failure, while a high level necessitates further investigation. Professor Sindone explained that if a patient with shortness of breath has an NT-proBNP level below 125, heart failure is unlikely. Conversely, levels above 300 may indicate potential heart failure, although other conditions like renal failure and severe lung disease can also elevate NT-proBNP levels.
“This test is effective for triaging patients and ensuring they receive appropriate care early,” said Professor Sindone. It helps avoid unnecessary echocardiograms for those who do not need them. If patients do not have heart failure, they won’t need to see a cardiologist; however, if they do, there are treatments available that can reduce mortality and hospital admissions.
In countries like the UK, NT-proBNP serves as a preliminary test before a patient is referred for an echocardiogram.
Professor Sindone emphasized the severity of heart failure, noting its worse prognosis compared to many cancers. “Fifty percent of individuals will die within five years of diagnosis,” he stated. He argued that just as immediate treatment is initiated for advanced cancers, similar urgency should be applied to heart failure cases.
Professor Sindone also contributed to the SHAPE study, which estimated that around 580,000 Australians suffer from reduced ejection fraction (HFrEF), with up to one million affected when including those with preserved ejection fraction (HFpEF). This figure is significantly higher than expected. HFpEF patients tend to be older women with conditions such as high blood pressure and diabetes, while HFrEF is more common among individuals with a history of heart attacks or valvular heart disease.
A 2022 study named STRONG-HF found that treatment for heart failure guided by repeat NT-proBNP testing could lower mortality and hospital readmissions by one-third.
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