Concept of disposable duodenoscope: at what cost?

Message

Although most postendoscopic retrograde cholangiopancreatography (ERCP) biliary tract infections are attributed to suboptimal ductal drainage, transmission of infection by contaminated reusable duodenoscopes has been reported. To overcome this limitation, a disposable duodenoscope has been recently developed. However, given the widespread use and large volume of ERCPs being performed worldwide, the financial viability of this novel concept is unclear. Utilising an activity-based costing and financial model, we estimated that the per-procedure cost of a disposable duodenoscope in the United States can vary from $797 to $1547 for centres performing at the 75^th percentile of ERCP procedure volume and from $1318 to $2068 for centres performing at the 25^th percentile of procedure volume, based on infection rates of 0.4% to 1%, respectively. However, when infection was not factored, the per-procedure cost decreased to $297 and $818 for centres performing at the 25^th and 75^th percentiles, respectively.

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Given the recent...

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