You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II (PD41)1 Sep 2021PD41-09 VARIABILITY IN COST-EFFECTIVE PRICE POINTS FOR SINGLE-USE CYSTOSCOPES BASED ON PRACTICE VOLUME: A REAL-WORLD ANALYSIS OF TWO PRACTICES IN A MAJOR URBAN CENTER Evan Garden, James Young, Osama Al-Alao, Darren Deoraj, Greg Hruby, Alexander Small, and Michael Palese Evan GardenEvan Garden More articles by this author , James YoungJames Young More articles by this author , Osama Al-AlaoOsama Al-Alao More articles by this author , Darren DeorajDarren Deoraj More articles by this author , Greg HrubyGreg Hruby More articles by this author , Alexander SmallAlexander Small More articles by this author , and Michael PaleseMichael Palese More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002051.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The traditional cost of reusable cystoscopes (RC) is derived from up-front purchasing, repair fees and equipment reprocessing, whereas single-use, disposable cystoscopes (DC) trade off these indirect expenses for higher direct costs. Therefore, the point at which DCs become more cost-effective than RCs depends primarily on the price of the DC itself. We sought to define the optimal price point for cost-effectiveness of the Ambu® DC (aScope™ 4) versus the Olympus® digital RC (CYF-VHR and V2) for cystoscopies performed in two outpatient clinical settings: a high-volume (HV) multi-provider practice and low-volume (LV) single-provider practice. METHODS: The number of cystoscopies performed at HV and LV between 1/2019-12/2019 was recorded. A micro-costing analysis was performed for DC and RC procedures, incorporating purchasing price, sterilization supplies, repair fees, and personnel costs. Using a variable pricing model, the optimal DC price was calculated – that is, the price of each individual DC, valve seal, and stopcock at which the per-case cost for cystoscopy performed with DC and RC was equal. RESULTS: Cystoscopies performed at the HV [n=1984] and LV[n=245] utilized nine and two RCs, respectively. Taking into consideration relevant expenses for procedures at each clinic, the HV operated at a cost of $65.98/case and the LV operated at a cost of $232.62/case with reusable equipment. For a complete transition from reusable-to-disposable equipment to be economically feasible, the HV would need to purchase each DC at a maximum price of $46.60 to maintain cost-effectiveness. At the LV practice the maximum cost-effective price for DCs would be $28.64. CONCLUSIONS: For both practices, an economically feasible DC price was <$50. This price was lower for the LV practice, suggesting that a practice run entirely with disposable equipment may be less financially feasible for low- versus high-volume clinics. Purchasing groups must be familiar with the economic implications of varying price points during negotiations to mitigate financial strain on the practice. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e684-e684 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Evan Garden More articles by this author James Young More articles by this author Osama Al-Alao More articles by this author Darren Deoraj More articles by this author Greg Hruby More articles by this author Alexander Small More articles by this author Michael Palese More articles by this author Expand All Advertisement Loading ...

Introduction: Disposable single-use cystoscopes have become increasingly available, demonstrating comparable quality to reusable cystoscopes while eliminating the need for reprocessing and repairs. However, high costs remain a concern. To clarify the role for these scopes, we performed a cost analysis comparison between the single-use Ambu (R) aScope (TM) 4 cystoscope and reusable Olympus (R) CYF-VHR and V2 cystoscopes in 2 clinical settings: a high- volume multi-provider practice and low-volume single-provider practice. Methods: The number of cystoscopies at each center was recorded between January and December 2019. Elements in the micro-costing analysis included the original purchasing price of the cystoscopes plus accessory equipment, sterilization supplies, repair costs, and personnel. Costs were amortized over 5 or 10 years and calculated on a per-case basis. An annual total cost analysis was performed to evaluate the cost-effectiveness of each device for each facility. Results: In 2019, 1,984 and 245 cystoscopic procedures were performed at the high and low-volume clinics, respectively. At the high-volume multi-provider practice, per-case cost for reusable cystoscopy amounted to $65.98 compared to $227.18 for single-use cystoscopy, with reusable equipment more cost-effective after 294 cystoscopies. At the low-volume single-provider practice, the per-case cost for reusable cystoscopy was $232.62 compared to $461.18 for single-use cystoscopy, with reusable equipment more cost-effective after 19 cases. Conclusions: Based on this micro-costing analysis, per-case costs favor reusable cystoscopes. While single-use cystoscope pricing may be prohibitive for large and small facilities at this present time, these instruments are powerful adjuncts to urologists' armamentaria when portability and efficiency are prioritized.