Cost of reusable gastrointestinal endoscopes to the NHS: findings from a micro-costing study

We aimed to quantify the per-procedure costs of acquiring, maintaining/repairing and reprocessing reusable gastrointestinal endoscopes by observing practices in a large National Health Service (NHS) hospital.

We conducted a bottom-up micro-costing analysis to capture the costs of reusable gastrointestinal endoscopes using a detailed resource-use data sheet and observations at the University Hospital Coventry and Warwickshire (UHCW). The data sheet drew on the published literature and NHS decontamination guidance. Cost categories included (1) measuring personnel time for reprocessing endoscopes, (2) reprocessing materials and (3) acquisition and maintenance/repair of endoscopy and reprocessing equipment. Data were obtained through observation and interviews with staff. Costs were calculated using the data collected at UHCW and cross-checked with data from two other NHS Trusts, manufacturers and the literature.

Staff time for reprocessing averaged 35 min per procedure (£23.57: 22% of the total cost). The reprocessing materials' cost per procedure was £16.41 (15% of the total cost). Total capital acquisition cost per procedure was £46.9 (44% of the total cost), including endoscopy capital (£37.4) and reprocessing capital (£9.5). Total maintenance/repair cost per procedure was £20.46 (19% of the total cost). These led to a total cost of £107.34 per endoscopy procedure.

Some observed values were slightly lower than but generally comparable to similar studies. We identified the key drivers of costs, led by capital costs. The results of our study could be used in economic evaluations involving reusable gastrointestinal endoscopes. The methodology can inform the cost evaluation of medical devices that require intensive reprocessing.