by Brian Howard
Vizient Director, Contract Services

The disposable endoscopes market was valued at $1.3 billion in 2020 and is expected to grow 16.9% from 2021 to 2028 due to the low cost of maintenance, the rising prevalence of chronic diseases and concerns over cross-contamination of reusable scopes. A growing number of providers are exploring a potential shift from reprocessed to single-use endoscopes for their hospitals and outpatient facilities.

With 75 million endoscopies conducted each year, a transition will require careful consideration and planning. As a best practice when pursuing this shift, facilities will want to work with clinicians to explore possible clinical, financial and operational impacts that transitioning to these new devices will have on each organization and their patients.

Financial considerations

When evaluating the options, the financial team and chief financial officer must be part of the analysis. Budgets will need to be modified and may impact different business units, including capital, reprocessing and respiratory. Several factors to consider include acquisition costs, staff training, additional costs (such as reprocessing and maintenance costs) and possible reimbursement.

The acquisition costs for capital equipment for reusable endoscopes typically include the cost of each scope ($25,000–60,000), the cost of a video tower ($60,000–75,000) and the cost of the reprocessor ($35,000–50,000). Reusable scopes require higher levels of continuous training and skills for physicians and nurses. Reusable scopes need to be reprocessed after each use and repaired when they either fail a leak test or have a functional failure that could negatively affect a patient during a procedure, costing an average of up to $130 each. Single-use endoscopes eliminate large capital expenditures, require a lower level of training and skills and eliminate costs related to reprocessing and repair.

In June 2020, the Centers for Medicare & Medicaid Services approved transitional pass-through (TPT) payments for single-use endoscopes to facilitate new and innovative technology access. The device-specific payment is in addition to the endoscopic retrograde cholangiopancreatography procedural payment and will vary by hospital. Commercial payers are not required to follow Medicare payment levels; however, some may choose to do so.

In general, a reusable endoscope averages $1,400–1,900 per procedure, while a single-use scope ranges from $400–1,900 per procedure.

Clinical considerations

Another consideration when evaluating reprocessed vs single-use endoscopes is the potential for infection. Reports of clusters of infections traced to contaminated duodenoscopes led to a study by the U.S. Food and Drug Administration (FDA) which found a 9% contamination rate for duodenoscopes. The FDA then recommended that health care facilities and manufacturers begin transitioning to duodenoscopes with disposable components to reduce the risk of patient infection.

A patient infection can be drastic and damaging to a hospital’s reputation—and can be catastrophic for some patients. With health care-associated infections occurring in 1% to 1.2% of procedures, the cost can range from $11,500–45,000 per procedure.

Single-use endoscopes eliminate the chance of patient infection due to cross contamination. As health care organizations continue to reduce health care-associated infections, many organizations are considering the possibility of endoscope-associated infections as part of their evaluation.

A growing market

These considerations, along with technological advancements and increasing applications, are among the primary factors driving the market growth for single-use endoscopes that were once held by only a few manufacturers. Additional signals of this continued shift include device manufacturers actively growing their single-use scope portfolios and new types of disposable devices and manufacturers entering the market every year. More information about market trends, including device manufacturers, is available in Vizient’s latest Medical Device Tech Watch.

If you do make the change, know that adoption will be a gradual process as surgeons become comfortable with the disposable scope and the hospital analyzes the number of procedures where a single-use/reusable scope is appropriate. Initiating a strategic assessment now will help ensure your organization is prepared in this evolving and dynamic market.

About the author: Brian Howard joined Vizient in 2017 and is currently a Director on the Physician Preference team with responsibilities over executing orthopedics' national and strategic objectives. Before his career at Vizient, Brian spent five years working for Equinox Fitness clubs in various leadership roles. Brian holds a BS from Indiana University-Bloomington and an MS degree from Texas A&M College Station.

Published: July 21, 2021