Cost Implications for Single-Use and Reusable Flexible Bronchoscopes

Single-use flexible bronchoscopes (SUFBs) have been gaining popularity owing to their portability and reports of infections related to reusable flexible bronchoscopes (RFBs). Hence, a need has arisen to compare the costs of using each type. This study sets out to assess the per-use cost of an RFB as a point of direct comparison to that of SUFBs in a single healthcare delivery unit.

This is a prospective, observational study in which we followed 25 RFBs throughout their use cycle. We applied a micro-costing approach that encompassed scope capital, servicing, staffing, and reprocessing costs to derive the per-use cost for RFBs. A sensitivity analysis provided data regarding how the per-use cost varies with bronchoscope fleet size and procedure volume. The per-use cost of RFBs was compared with the price of SUFBs.

The per-use cost of RFBs was USD 198.26 to USD 202.40, and SUFBs were USD 300.00 to USD 400.00 each in the endoscopy unit. The RFB cost was primarily attributed to scope capital and servicing costs but was highly variable across procedural volume and scope fleet size. Sensitivity analysis showed that as case volume increases, the per-use cost drops in a nonlinear fashion, and as scope fleet increases, the per-use price increases accordingly. In high-volume units (>900 annual procedures), RFBs are the more cost-effective option, whereas in low-volume units (<400 annual procedures), cost favors SUFBs. For medium-volume units (400-900 annual procedures), SUFBs and RFBs are largely comparable in cost.

SUFBs offer cost savings in low-volume units, whereas high-volume units may favor RFBs. The additional implications of environmental impact and risk of nosocomial infection need be considered.