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
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.”