DIAGNOSTICS ASSESSMENT PROGRAMME

1 Recommendations

1.1 Using FibroScan to assess liver fibrosis or cirrhosis for adults in primary or community care has potential to provide significant patient and healthcare system benefits. However, there is not enough certainty to recommend it as a clinically effective and cost saving option for routine use.

1.2 More evidence is needed to address uncertainty about the relative performance of FibroScan testing when done in primary or community care compared with its use in secondary or specialist care. Additional assessment of the total costs of doing the test in and outside secondary or specialist care is also needed. See further research and section 3.7 for more details.

Why the committee made these recommendations

There may be benefits to using FibroScan in primary and community care for assessing liver disease. These benefits may include improved convenience for patients, increased attendance at appointments and greater detection of liver disease. However, the company's analysis did not provide enough certainty that the test performance would be preserved when done in primary or community care, potentially by less experienced staff.

There is uncertainty if the cost for FibroScan used in the company's analysis is an accurate reflection of the true cost of doing the test, both in and outside secondary or specialist care. There was no evidence that using FibroScan in primary or community care would improve outcomes. This added to uncertainty about whether using FibroScan in primary or community care would be cost saving. Therefore, it cannot be recommended for routine use and more evidence is needed to address the uncertainties.