Switching to Single-use Flexible Ureteroscopes for Stones Management: Financial Impact and Solutions to Reduce the Cost Over a 5-Year Period

Urology ◽  
2020 ◽  
Vol 143 ◽  
pp. 68-74 ◽  
Author(s):  
Sophie Dubnitskiy-Robin ◽  
Benjamin Pradère ◽  
Benjamin Faivre d'Arcier ◽  
Sophie Watt ◽  
Tanguy Le Fol ◽  
...  
Keyword(s):  
Financial Impact ◽  
Flexible Ureteroscopes ◽  
Single Use ◽  
The Cost

scholarly journals Vantagens custo-efetivas da utilização de ureteroscópios flexíveis descartáveis em comparação com o uso de ureteroscópios flexíveis reprocessáveis

2021 ◽  
Vol 13 (1) ◽  
pp. 55-65
Author(s):  
Nathalia Sper ◽  
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Joint Analysis ◽  
Flexible Ureteroscope ◽  
Flexible Ureteroscopes ◽  
Single Use ◽  
The Cost ◽  
Positive Return ◽  
Flexible Models

Objective: To analyze the cost-effectiveness of using disposable flexible ureteroscopes versus using reprocessable flexible ureteroscopes. Methods: Integrative literature review conducted in the SciELO, LILACS and MEDLINE databases, using the descriptors ureteroscopy, flexion resistance, marketing, cost-benefit analysis, and sterilization, whose object deals with the cost-effective advantages of using the flexible ureteroscope disposable. Results: Thirty-five articles were found and four were used in the study. In addition, characteristics of seven models of flexible ureteroscopes commercialized in Brazil, that are currently better known, were presented. The results were based on a joint analysis of the selected articles and characteristics of the flexible models presented, and discussed in two categories: the evolution of flexible ureteroscopes; and marketing mix - flexible single-use ureteroscopes. Conclusion: Despite the scarcity of research that deepens the costs of using a flexible single-use ureteroscope when compared to a reprocessable one, the benefits arising from the innovations added to these devices are notorious, giving a positive return both to the professional who uses it and to the patient, making it necessary to further analyze the possibility of migration from the “culture” of using flexible reprocessable ureteroscopes to disposable ones

The Cost of Ureteroscopy: Can Single-Use Flexible Ureteroscopes Advance Past Reusable?

Videourology ◽  
2019 ◽  
Vol 33 (4) ◽  
Author(s):  
Christian Tabib ◽  
Vinaya Vasudevan ◽  
David Hoenig ◽  
Zeph Okeke ◽  
Arthur Smith
Keyword(s):  
Flexible Ureteroscopes ◽  
Single Use ◽  
The Cost

scholarly journals Single-use versus reusable flexible ureteroscopes: a comprehensive cost-analysis decision model

2018 ◽  
Vol 97 (3) ◽  
pp. 323-333
Author(s):  
Giovanni Scala Marchini ◽  
Fábio César Miranda Torricelli ◽  
Manoj Monga ◽  
Carlos Alfredo Batagello ◽  
Fábio Carvalho Vicentini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Case Series ◽  
Final Analysis ◽  
Flexible Ureteroscopy ◽  
Complication Rates ◽  
Ureteral Access Sheath ◽  
Flexible Scope ◽  
Surgical Costs ◽  
Single Use ◽  
The Cost

Purpose: The significant improvements in flexible ureterorenoscopes have made flexible ureteroscopy the main treatment modality to target upper urinary pathologies. The purpose of this study was to critically evaluate all literature concerning the cost-effectiveness of flexible ureteroscopy comparing single-use with reusable scopes. Methods: A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. Two separate urologists (GSM and FCT) performed the online search and reviewed all papers considered suitable and relevant for this analysis. Because of the paucity of high quality publications, not only prospective assessments but also case control and case series studies were included in the final analysis. All factors potentially affecting surgical costs or clinical outcomes were considered in the analysis. Results: 741 studies with the previously elected terms were found. Of those, 18 were duplicated and 77 were not related to urology procedures and were excluded. Of the remaining 646 studies, 59 published between 2000 and 2018 were considered of relevance to the pre-defined queries and were selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. In special, urinary tract infection rate following flexible ureteroscopy is not inferior if a single-use device is used instead of a reusable scope. Operative time was in average 20% shorter if a digital scope was used, single-use or not. There is a suggestion that the learning curve is shorter with single-use devices but this is not consistent in the literature. Surgeon expertise impacts the longevity of the flexible scope. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last three to four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Both sterilization method and cleaning process impact scope longevity, the best results being achieved with Cidex and a dedicated nurse to take care of the sterilization process. The main factors that negatively impact device longevity regarding patient and disease are lower pole pathologies, large stone burden and non-use of a ureteral access sheath. Conclusions: The cost-effectiveness of a flexible ureteroscopy program is dependent of several aspects that must be considered when deciding whether to choose between a single-use and a reusable ureterorenoscope. Disposable devices are already a reality and will progressively become the standard as manufacturing price falls significantly.

Stigmatized products: how conflicting laws can influence decisions to proceed

2020 ◽  
Vol 42 (1) ◽  
pp. 41-49
Author(s):  
Stephanie Geiger-Oneto ◽  
Betsy D. Gelb ◽  
Travis Simkins
Keyword(s):  
Design Methodology ◽  
State Legislatures ◽  
Strategic Decisions ◽  
Content Type ◽  
State Laws ◽  
Product Categories ◽  
Plastic Bags ◽  
Single Use ◽  
The Cost ◽  
Different Levels

Purpose The purpose of this paper is to offers the authors’ perspective on a problem rarely considered by those making strategic decisions: conflicting laws at different levels of jurisdiction, specifically those related to stigmatized products. Design/methodology/approach The authors use as examples of product categories from marijuana to single-use plastic bags, describing the conflicting laws that add to costs for marketers and consumers. Findings The authors find that conflicting laws add to the uncertainty, legal expenses, and therefore, the cost of marketing a stigmatized product, whether stigmatized because of its impact on the environment, on health or on moral grounds. Research limitations/implications The examples are not exhaustive, but their implications are significant: that as state legislatures are preempting local bans, Congress may preempt state laws. Originality/value This paper adds one more complexity to decision-making in the area of products to offer and/or merger/acquisition decisions that may bring company products that face conflicting laws.

Single-Use Flexible Ureteroscopes: How Do They Compare with Reusable Ureteroscopes?

2019 ◽  
Vol 33 (2) ◽  
pp. 71-78 ◽  
Author(s):  
Kymora B. Scotland ◽  
Justin Y.H. Chan ◽  
Ben H. Chew
Keyword(s):  
Flexible Ureteroscopes ◽  
Single Use

Is the introduction of single use flexible ureteroscopes capable of preventing reusable scopes breakages? Results from a high-volume center

2019 ◽  
Vol 18 (7) ◽  
pp. e2844
Author(s):  
E. Ventimiglia ◽  
S. Doizi ◽  
F. Quadrini ◽  
F. Pauchard ◽  
L. Villa ◽  
...  
Keyword(s):  
High Volume ◽  
Flexible Ureteroscopes ◽  
High Volume Center ◽  
Single Use

scholarly journals An Evaluation of Intravenous Infusion Pumps and Controllers

1987 ◽  
Vol 15 (2) ◽  
pp. 217-228 ◽  
Author(s):  
W. B. Runciman ◽  
A. H. Ilsley ◽  
A. J. Rutten ◽  
D. Baker ◽  
R. R. L. Fronsko
Keyword(s):  
Intravenous Infusion ◽  
Venous Pressure ◽  
Outlet Obstruction ◽  
Intravenous Fluids ◽  
Central Venous ◽  
Infusion Pumps ◽  
Peristaltic Pumps ◽  
Single Use ◽  
The Cost ◽  
Flow Controllers

The accuracy, safety, reliability and cost of use of 35 intravenous infusion pumps and 3 flow controllers were assessed. When infusing saline 11 out of 17 syringe pumps, 3 out of 5 peristaltic pumps, 1 out of 2 roller pumps and all 14 cassette pumps tested were accurate to within 5% over their full ranges of operation. There was no significant change in the performance of any of the pumps tested when saline was infused through a standard resistance, except in the cases of the 3 flow controllers which were unable to infuse at all against the resistance. When 50% dextrose was infused, delivery by two peristaltic pumps was reduced by 23 and 38%. No pump cut out or alarmed at pressures of up to 200 mmHg and 21 pumps continued to infuse against pressures of 750 mmHg or greater. Surges of up to 0.5 ml occurred after release of an outlet obstruction. One device was fitted with a variable high pressure alarm. This device could also measure pressure in the infused vessel and was found to be accurate for measurements of central venous pressure. The cost of consumables for a single use for syringe pumps ranges from A$2 to $5, for peristaltic and roller pumps from A$1 to $10, and for cassette pumps from A$7 to $12, with an additional A$2 for a burette. Accurate delivery of intravenous fluids and drugs is available but is expensive and requires the operator to be specially trained. No simple, cheap, accurate device is yet available.

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