Disposable cystoscopes more cost-effective than traditional reusable options, study finds

USA: Single-use flexible cystoscopy was found to be cost-efficient at a high-volume care centre, reports a 90-day trial data published in the journal Urology.

A global survey suggests, urologists are willing to shift to single-use cystoscopes in an average of nearly half (44.5%) of their cystoscopy procedures. A cystoscope is a long, thin optical instrument used to diagnose, monitor and treat conditions affecting the bladder and urethra in patients. Single-use flexible cystoscope advancements have introduced alternative options to reusable scopes.

In a few studies, disposable cystoscopes have shown comparable quality to reusable cystoscopes and offered a more streamlined process with no hidden costs associated with labour time, reprocessing equipment, and repairs, making the per procedure cost more transparent in a single-use setup. Also, the use of disposable ones is characterized by significantly lower post-operative complications and infection rates. However, there is a paucity of cost-effectiveness and provider satisfaction studies examining the implementation of a hospital-based transition to single-use cystoscopes.

Assmus MMA, Northwestern University, Chicago, USA and colleagues conducted a 90-day trial to evaluate the cost-effectiveness and user satisfaction of a single-use flexible cystoscope at a tertiary care centre.

Researchers encountered 84 cases (78 operatives, 5 inpatients, and 1 emergency department (ED)) over the 90 days, where all flexible, transurethral, and percutaneous, urologic care was provided with a disposable AMBU® aScopeTM. The research team performed a micro-costing analysis examining the payor per case cost of the reusable flexible cystoscope (including servicing & processing) to the disposable units. Provider surveys assessed visual quality, deflection, ease of working channel and overall satisfaction on a 10-point Likert scale.

Key findings of the analysis,

• One disposable flexible cystoscope was successfully used in 93% of cases. Failures in a few cases were due to an inability to access a disposable scope/monitor.

• Per use cost of the reusable flexible cystoscope at our centre was $272.41 versus $185.00 for single use.

• Based on average case volume and conservative failure rate, transitioning to predominately single-use scopes resulted in $39,142.84 annual cost savings.

The authors conclude that the per-use cost of a disposable flexible cystoscope was less when utilized at a high-volume tertiary care centre. Hospital-based transition to single-use cystoscopes is cost-effective and comfortable for the provider.

Reference:

Assmus MMA, Krambeck AE, Lee MS, Agarwal DK, Mellon M, Rivera ME, Large T. Cost-Effectiveness of 90-Day Single-Use Flexible Cystoscope Trial: Single Center Micro-Costing Analysis and User Satisfaction. Urology. 2022 Jun 27:S0090-4295(22)00520-9. doi: 10.1016/j.urology.2022.05.039. Epub ahead of print. PMID: 35772484.