Reusable ureteroscope durability and need for repair are significant sources of expense and inefficiency for patients and urologists. Utilization of LithoVue™, a disposable flexible digital ureteroscope, may address some of these concerns. To identify its economic impact on clinical care, we performed a micro-cost comparison between flexible reusable fiberoptic ureteroscopes (URF-P6™) and LithoVue™.
For this prospective, single-center micro-costing study, all consecutive ureteroscopies performed during one week each in July and August 2016 utilized either URF-P6™ or LithoVue™ ureteroscopes respectively. Workflow data were collected, including intraoperative events, post-operative reprocessing cycle timing, consumables usage, and scope cost data.
Intraoperative data analysis showed mean total operating room time for URF-P6™ and LithoVue™ cases were 93.4 ± 32.3 and 73.6 ± 17.4 minutes, respectively (p=0.093). Mean cost of operating room usage per case was calculated at $1,618.72 441.39 for URF-P6™ and $1,348.64 237.40 for LithoVue™ based on institutional cost rates exclusive of disposables. Postoperative data analysis revealed costs of $107.27 for labor and consumables during reprocessing for URF-P6™ cases. The costs of scope repair and capital acquisition for each URF-P6™ case were $957.71 and $116.02, respectively. The total ureteroscope cost per case for URF-P6™ and LithoVue™ were $2,799.72 and $2,852.29, respectively.
Micro-cost analysis revealed that the cost of LithoVue™ acquisition is higher per case compared to reusable fiberoptic ureteroscopes, but savings are realized in labor, consumables, and repair. When accounting for these factors, the total cost per case utilizing these two scopes were comparable.
Journal of endourology. 2017 Dec 14 [Epub ahead of print]
Kazumi Taguchi, Manint Usawachintachit, David T Tzou, Benjamin Sherer, Ian Metzler, Dylan Isaacson, Marshall Stoller, Thomas Chi
University of California San Francisco, Urology, San Francisco, California, United States., University of California San Francisco, 8785, Urology, San Francisco, California, United States ; ., University of California San Francisco, Urology, San Francisco, California, United States ; ., University of California, San Francisco, Urology, San Francisco, California, United States ; ., University of California San Francisco, School of Medicine , 513 Parnassus Ave , HSW 1434 , San Francisco, California, United States , 94143 ; ., University of California San Francisco, Urology, San Francisco, California, United States ; ., University of California San Francisco, Urology, San Francisco, California, United States ; .