The effect of displaying laboratory test prices on physicians’ ordering behaviour: a systematic review of European studies

Objective As European healthcare systems struggle with increasing workload and sustainability issues, it is estimated that 20% of their production is ineffective. One potential strategy to reduce this excess is by minimizing the use of unnecessary laboratory tests. The aim of this review was to investigate the effect of presenting physicians in Europe with the cost of laboratory tests at the time of ordering on the quantities and expense of laboratory tests as well as to identify knowledge gaps on this matter. Methods Following PRISMA guidelines, a systematic search in PubMed and EMBASE was conducted in February 2025. Studies were included if written in English and conducted in Europe. There were no restrictions on year of publication. Study quality was evaluated using a modified Downs and Black checklist. Results Of the 2185 publications identified, five met the inclusion criteria. All included studies were published 2002–2021 and found a reduction in order cost and/or volume of laboratory test, following price display (four with statistically significant results). The reduction in order costs were greater than the reduction in order volume. Additionally, the impact of price display diminished over time as the intervention period continued. None of the studies included patient safety measures. Conclusions Price display is a simple yet potentially impactful intervention as it is likely to reduce both the cost and volume of tests, thereby decreasing the workload and enhancing the sustainability of the healthcare systems. Further high-quality studies are needed to determine if price display is a patient-safe intervention.