24.10. Organisational cost savings and other benefits of sFLC analysis

Chapter 24

As well as improved clinical diagnosis, there are organisational cost savings and other benefits to introducing sFLC assays. The laboratory issues and costs were analysed in 2004 at the Christie Hospital in Manchester, UK [527]. Superior analytical performance of the serum assays, faster reporting times and reduced laboratory costs were identified (Table 24.1). Cost benefits in relation to clinical outcomes were not analysed in this study but they may accrue from earlier diagnosis and by treatments that reduce morbidity. It is well known that a delay in the diagnosis of MM is associated with more complications and reduced disease-free survival [526].

sFLCs Urine electrophoresis
Sensitivity 1.5 mg/L 50 mg/L
Precision 5% >15%
Analysis time 15 minutes 1 hour
Reporting turnaround 1 hour 1 week
Cost per year (700 requests) £6,500 £4,500
Extra staff costs per year £0 £1,000
24-hour urine bottle usage Not relevant £1,000
Storage needs 30 cm310 m3

Table 24.1. Analytical and cost/benefit study of sFLC and urine electrophoresis tests [527].

Most comparisons of the relative cost/benefits of serum versus urine FLC analysis have been made in the context of screening studies and these are presented in Section 23.6. In addition to the financial benefits, Tschautscher et al. [1082] comment that monitoring with sFLC analysis in place of 24-hour urine analysis is likely to result in better patient compliance, because urine tests are both bothersome and time consuming.