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Inclusion Of A Novel Ibs Blood Panel For Diagnosing Diarrhea Predominant Irritable Bowel Syndrome (Ibs-D): A Uk Perspective

      Objectives

      UK guidelines for the diagnosis of IBS in patients who meet diagnostic criteria include FBC, ESR, C - reactive protein and testing for coeliac disease to exclude other diseases. Despite these recommendations, referral for procedures such as flexible sigmoidoscopy, colonoscopy and ultrasound scanning continue and in the majority of this patient group, are considered to be unnecessary, subsequently placing an increased cost burden to National Health Services (NHS). A novel IBS diagnostic blood panel has been developed which tests for the presence of two biomarkers associated with IBS-D. This analysis estimates the potential cost impact to the NHS by introducing this test into the diagnostic pathway of IBS.

      Methods

      Budget impact was based on a cost-minimization model to compare the costs associated with two possible diagnostic pathways: (1) with a novel IBS diagnostic blood panel and (2) exclusionary pathway and applied to the UK population 18-65yrs old. Model structure was based on current literature/ guidance from IBS expert. Direct medical expenses include, labs, diagnostic procedures, visits in £ and weighted by utilization provided by a practicing gastroenterologist in the UK.

      Results

      Gastroscopy, flexible sigmoidoscopy, and colonoscopy were the most common diagnostic (instrumental) procedures reported with estimated utilization rates of 55%, 55% and 35%, respectively. Corresponding charges were £200, £400 and £400, respectively. Net savings in the base case of £57 favored the IBS diagnostic blood panel pathway (assumes 75% of test positive patients receive IBS-D treatment) vs the exclusionary pathway. If clinicians use the test 50% of the time for the 30% of the estimated 446,382 people who might have IBS-D who seek treatment, net potential savings to NHS is £12,721,891.

      Conclusions

      Inclusion of a novel IBS diagnostic blood panel in the diagnostic pathway has the potential for significant cost savings due to the avoidance of unnecessary testing.