The cost-effectiveness of reusable flexible ureteroscopes: An institutional audit

Abstract

ABSTRACT Introduction: A flexible ureteroscope (FU) is an important tool in the urologist’s armamentarium. This study aims to check the durability and cost-effectiveness of conventional FU. Methods: The institution registry of damaged FU over the last 7 years was reviewed. A total of 17 flexible scopes were used. The data of 13 scopes (11 Storz fiberoptic and 2 Seesheen digital) are included in this study. A total of 1905 cases were performed. The cost of scope, duration of use, number of cases done by each scope, and nature of damage were evaluated. We compared the cost-effectiveness of conventional scopes with published costs on disposable scopes. Results: The mean number of cases done by fiberoptic scope was 159 (range 25–334). The total cases done by 2 digital scopes were 135 and 25. The mean life of fiberoptic and digital scopes was 17 (range 4–31) and 8 months, respectively. The mean cost of fiberoptic scope was Indian Rupee (INR) 338,951 ($4082.7221) and INR 525,000 ($6323.7138) for digital scope. The cost per case for reusable scope is calculated by dividing the mean cost of FU by the mean number of cases done. The reprocessing cost of INR 527 was then added. Thus, the average cost per procedure for fiberoptic and digital FU was INR 2658.76 and INR 7089.50, respectively. We compared this cost with a projected cost of disposable FUbased on today’s market data, which ranged from INR 60,000 to 107,427. Conclusions: The reusable scopes are durable, cost-effective, and an excellent option for high case-load institutions.