Ultrasound test to replace invasive biopsy for liver fibrosis in NHS

9 January 2012

A non-invasive ultrasound test is set to reduce the need for liver biopsy across the NHS, saving over £500 on each test, following a guide published by the NHS Technology Assessment Centre (NTAC).

The guide, commissioned by the NHS, will help all acute hospital trusts across the NHS undertake the practical steps to implementing this non invasive and cost effective diagnostic procedure rapidly.

The NHS Technology Adoption Centre (NTAC) studied the implementation of ultrasound elastography within secondary care at three NHS trusts: King’s College Hospital NHS Foundation Trust, The North West London Hospitals NHS Trust and East Cheshire NHS Trust. They then drew up the pack of information and practical tools based on their findings that will help clinicians and managers in NHS trusts implement this new technology.

Economic modelling based upon real life implementation was produced by York Health Economic Consortium along with a bespoke costing tool that can help to inform local providers/commissioners of the potential savings that can be made.

York estimated a gross saving of £520 each time a liver biopsy is replaced with an ultrasound elastography. When extrapolated across the NHS, this equates to a saving of £14.3m per annum based on current numbers.

The prevalence of liver disease is on the increase in the UK. One report from 2011 suggests that the number of people with liver disease in England is 2.3million, which equates to approximately 5% of the total population. Later stage liver disease, liver fibrosis, is associated with significant morbidity and mortality. Establishing the presence and extent of liver fibrosis is therefore crucial in managing a patient’s health.

Previously an assessment of liver fibrosis could only be determined by undertaking a liver biopsy. There are considerable downsides to this procedure, due to its invasive nature, an inherent risk of infection and the high costs of a surgical procedure and hospital attendance as an in-patient. The use of ultrasound elastography, a non-invasive method of monitoring liver fibrosis, provides a safer and quicker diagnosis with no discomfort or worries about a surgical procedure for the patient as well as reducing costs by an estimated £520.

NTAC Technology Implementation Manager, Stephen Hodges, said “This technology has had a very positive impact both for patients and for the NHS. It enables doctors to diagnose and monitor liver fibrosis much more closely than ever before and does so in a pain-free, safe and cost-effective way.”


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