Disposable flexible cystoscopes for removing double J catheter A budget impact analysis

Abstract

Introduction: We conducted a budget impact analysis to evaluate the cost of removing double J catheters using single-use flexible digital cystoscopes compared to reusable cystoscopes at the CHU de Québec.

Methods: The UETMIS of CHU de Québec estimated average costs per intervention for both reusable and single-use flexible cystoscopes in the endoscopy room. Costs included purchase, repair, reprocessing, and sterilization for reusable cystoscopes based on data from 2017-2019. For single-use cystoscopes, the unit price and technical platform costs were considered. Annual costs were calculated using the average cost per procedure and the annual volume of double J catheter removals.

Results: The average cost per intervention for reusable flexible cystoscopes was estimated at $148.55, while for single-use digital flexible cystoscopes, it was $293.38. For 385 annual double J catheter removals, the total cost would be $57 191.75 with reusable cystoscopes and $112 951.30 with single-use cystoscopes. This represents an additional cost of $144.83 per procedure or $55 760 annually when using single-use cystoscopes.

Conclusions: The use of single-use flexible digital cystoscopes for double J catheter removal at CHU de Québec would nearly double the cost per procedure compared to reusable cystoscopes. This cost difference is primarily due to the purchase price of single-use devices. While cystoscope breakage is infrequent, the potential for higher breakage risk during double J catheter removal could reduce the cost differential. Future implementation of patient-focused financing might alter the economic evaluation of single-use cystoscopes.