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PTU-330 A pragmatic business case for fibroscan service
  1. A Ramakrishnan,
  2. S Chandrapalan,
  3. S Thomas
  1. Gastroenterology, University Hospital of North Midlands NHS Trust, Newcastle Under Lyme, UK

Abstract

Introduction Liver disease is the only disease with increasing mortality of the chronic diseases in UK. Lancet commission recommended early identification of cirrhosis and addressing of risk factors as ways to decrease mortality. Fibroscan helps to identify fibrosis at an early stage in a non-invasive manner with clinical incremental effectiveness of at least 17% to existing methods but is expensive.

Method We loaned an old Fibroscan machine from Echosens to prove the cost effectiveness to put forward a successful business case using the NHS technology adoption centre (NTAC) model. 4 operators trained in Fibroscan used the machine (1stgeneration machine - M probe only) over 4 months (February to June 2013) using validated definitions for fibrosis and success.

Results 108 Fibroscan were done during 4 month period with 60 scans (56%) being valid. M: F 44: 16, Median age 47 (Range 21–78). Diagnoses were Hep C 27% (16), Hep B 25% (15), NAFLD/Crypto 18% (11), ALD 17% (10), Hemochromatosis 5% (3), PBC 3% (2), others 5%. 50% (30/60) had no significant fibrosis, 38% (23/60) had significant fibrosis and 12% (7/60) had ≥ F2 ≤ F3 fibrosis.

Gross money saved using the NTAC model was £102,817. Since the increment would have been only 17% with Fibroscan, net money saved over 4 months was £17478.89, amounting to £52436.67/year

Conclusion Fibrosis and success was comparable to published data. Our pragmatic approach enabled us to successfully prove the NTAC model for business case using a loaned 1stgeneration Fibroscan machine and set up Fibroscan services.

Disclosure of interest None Declared.

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