Assessment of the economic relevance of the use of single-use digital flexible ureteroscopes
A systematic review
DOI:
https://doi.org/10.5489/cuaj.8798Keywords:
single-use, ureteroscope, economic, cost-effectivenessAbstract
INTRODUCTION: Breakages and repairs related to flexible digital reusable ureteroscopes (flURS) are expensive. Thus, we aimed to assess the cost-effectiveness of single-use flexible digital ureteroscopes ureteroscopes (SUFDU).
METHODS: We conducted a literature review on MEDLINE and EMBASE until September 19, 2018. Systematic reviews and guidelines were assessed for methodologic quality by using standardized grids (R-AMSTAR and AGREE-II). Original studies were analyzed according to local customized grids. The Critical Appraisal Skills Program (CAPS) tool enabled the assessment of the economic aspects in the literature. We also collected local data over a year in 2017–2018 and conducted an economic evaluation by cost minimization, comparing SUFDU and flURS in our center. By generating different flURS breakage reduction scenarios, we aimed to demonstrate the budgetary impact SUFDU introduction would have in our center.
RESULTS: Five economic studies were included. Data on flURS showed breakage rates between 6.4–13.2%, and mean numbers of interventions before breakage of 7.5–14.4. Four of the five economic analyses suggested a higher cost per intervention with SUFDU. Our local data demonstrated similar results (6.4% and 11.8 cases) and enabled us to estimate the annual number of ureteroscopies for which SUFDU would become profitable: 11–26 (depending on the chosen device). Furthermore, we illustrated how selective use of SUFDU can reduce annual costs by avoiding breakages in different scenarios.
CONCLUSIONS: The mean cost per intervention with SUFDU is usually higher than with flURS in high-volume centers and exclusive use becomes unprofitable from a small number of cases.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:
- Post the Article on any Web site
- Translate or authorize a translation of the Article
- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.
The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.
You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.
The CUA also requires you to warrant the following:
- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
- That all individuals who have made a substantive contribution to the article are acknowledged;
- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
- That the Article does not libel or violate the privacy rights of any third party.
