Our objective was to assess the effectiveness, safety and efficiency of a protocol combining fetal fibronectin diagnostic testing and atosiban tocolysis for the management of pre-term labour, using a combination of narrative review and economic modelling. We compared the proposed protocol to alternatives using nifedipine with or without fetal fibronectin. We have found that the proposed protocol may be safer and more acceptable by women than the alternatives, and its use can result in significant cost-savings.