The Economic Implications of a Reusable Flexible Digital Ureteroscope: A Cost-Benefit Analysis

Questions still remain regarding the durability and longevity of flexible ureteroscopes (URS). The objective of this manuscript is to estimate potential economic benefits of the single use flexible digital URS compared to our recent experience with reusable flexible digital URS using cost benefit analysis.

Ureteroscopic procedures were prospectively recorded over a 12-month period (February 2014 - February 2015). All flexible ureteroscopies were performed using the Karl Storz Flex-XC™ digital ureteroscopes. Cost assessment was based on the original purchasing cost and repair-exchange fees divided by number of cases. An algorithm was made to include per case reprocessing costs and to calculate benefit-cost ratio (BCR). This cost was compared to potential costs of the Boston Scientific LithoVue™, a single use digital URS.

One hundred and sixty cases utilized a flexible reusable URS. There were a total of 11 URS damages during this time period, with average cases to failure being 12.5 cases. Excluding original purchasing costs, the cost analysis reveals an amortized cost of $848.10 per use. After 99 URS cases, cost-benefit analysis favors reusable URS compared to disposable URS.

Digital URS is the latest trend in the evolution of endourology. It appears that a disposable URS may be cost beneficial in centers with lower case volumes per year, but institutions with high volume of cases may find reusable URS cost beneficial.

The Journal of urology. 2016 [Epub ahead of print]

Christopher J Martin, Sean B McAdams, Haidar Abdul-Muhsin, Victoria M Lim, Rafael Nunez-Nateras, Mark D Tyson, Mitchell R Humphreys