Single-Use Grasper Integrated Flexible Cystoscope for Stent Removal: A Micro-Costing Analysis-Based Comparison

Area of Science:

• Urology
• Health Economics

Background:

• A new single-use flexible cystoscope with an integrated grasper (Isiris) is now available.
• Comparing the cost-effectiveness of single-use versus reusable cystoscopes for stent removal is crucial for clinical practice.

Purpose of the Study:

• To compare the costs of stent removal using the single-use Isiris system versus a traditional reusable cystoscope and stent grasper in an outpatient setting.

Main Methods:

• A micro-cost assessment was performed, analyzing purchasing price, repair, sterilization, reprocessing, and labor costs for a reusable cystoscope.
• Costs were estimated on a per-use basis and compared to the purchasing price of the single-use Isiris device.
• Data on stent removal procedures were collected from February 2016 to February 2017 at a tertiary center.

Main Results:

• The reusable cystoscope was used for 871 (49%) of 1775 cystoscopic procedures.
• The estimated per-use cost for stent removal with a reusable cystoscope was $161.85, compared to $200 for the single-use Isiris device.
• The break-even point favoring the reusable cystoscope was calculated at 704 stent removals.

Conclusions:

• Per-use costs for stent removal favor the reusable cystoscope over the single-use Isiris system.
• Centers with a high volume of stent removal procedures are likely to find reusable cystoscopes and stent graspers more cost-beneficial.