Micro-cost analysis of reusable compared to affordable single-use flexible ureteroscopes

Area of Science:

• Urology
• Health Economics
• Medical Device Technology

Background:

• Flexible ureteroscopy (fURS) is vital for upper urinary tract conditions, especially kidney stones.
• The economic impact of emerging single-use fURS versus reusable systems requires evaluation.
• A micro-cost analysis was conducted within a Canadian single-payer system.

Purpose of the Study:

• To compare the cost-effectiveness of reusable fURS against two single-use models.
• To determine the break-even points for reusable fURS based on procedure volume.
• To analyze repair data for reusable fURS to inform cost calculations.

Main Methods:

• Cost analysis included acquisition, repair, and reprocessing for reusable fURS.
• Per-procedure costs were calculated based on total annual expenses and procedure volume.
• Single-use fURS costs were based on device prices; repair data was collected from 2022-2024.

Main Results:

• Reusable fURS cost $245.03 per procedure at an annual volume of 418 cases.
• Reusable fURS are more cost-effective above 130 cases (vs. EU-Scope™) and 83 cases (vs. LithoVue™).
• 65 repairs occurred from 2022-2024, primarily due to distal tip leakage (77%), with one repair per ~20 procedures.

Conclusions:

• Reusable fURS demonstrate superior cost-efficiency in high-volume urological procedures.
• Single-use fURS may offer economic advantages in low-volume settings.
• Using single-use fURS in tertiary centers can preserve reusable scope longevity during high-risk procedures.