One previously published economic evaluation was included in the 2010 guideline update (CG108) which assessed NP guided monitoring to usual care based on a clinical trial by Troughton et al. 2000339 . However, a US Medicare perspective was taken and therefore this study has been excluded from this review in line with the protocol. An original economic analysis was conducted for this question in the 2010 guideline. An update of this analysis with the addition of new clinical evidence has been included in this review.191 A further two health economic evaluations were identified with the relevant comparison and have been included in this review.223 These are summarised in the health economic evidence profile below (Table 83) and the health economic evidence tables in Appendix G. See also the health economic study selection flow chart in Appendix D. Monitoring Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Table 83: Health economic evidence profile: NP guided therapy versus usual care Study Applicability Limitations Other comments Costs Effects Inc. cost Inc. effects Cost- effectiveness Uncertainty Laram e [UK] Directly applicable(a) Minor Limitations (b) Cost-utility analysis, Monte Carlo simulation model Comparators: 1. Usual care in the community 2. Specialist clinical assessment natriuretic peptide monitoring Lifetime horizon modelled Population split into multiple sub-groups: o Patients with CHF and LVSD 1. n/a 1. n/a - - - - QALY gained o Patients with CHF and LVSD aged <75 years 1. n/a 1. n/a - - - - 2. NR 2. NR Baseline Probability cost- 3. NR 3. NR NR NR 2,871 per QALY gained o Patients with CHF and LVSD aged 75 years 1. n/a 1. n/a - - 2. NR 2. NR Baseline Probability cost- 3. NR 3. 