A literature review found the total cost per procedure for an endoscopic retrograde cholangiopancreatography (ERCP) with a reusable duodenoscope to average between $849.24 and $1,907.61.

David Hoffman, a health economist with Ambu USA, presented a poster summarizing the findings of a systematic review May 8 at DDW 2023 in Chicago.

The review also found that the cost per procedure was lower in higher procedure-volume centers than in low procedure-volume centers despite increased capital requirements. Single-use duodenoscopes may serve as an option for facilities to balance high costs while reducing potential infection risks, and also navigating the changing landscape of reprocessing and repairs associated with reusable duodenoscopes.

Single-Use Endoscopy is an online learning center powered by Ambu USA, which manufactures single-use duodenoscopes.

ERCP is common endoscopic procedure intended to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas such as blockages, leakage, tumors and infections

Five studies were included in the analysis, where the average cost of a reusable duodenoscope came out to $40,000. The cost of one duodenoscope reprocessing cycle done with high-level disinfection in an automated endoscope reprocessor ranged from $80 to $103 per cycle. Scope culturing — which is being done more frequently due to increased guidance from the FDA and healthcare associations — costs $152.20 per procedure on average.

A sensitivity analysis found the cost of an ERCP, including capital investment, repairs, reprocessing, scope culturing, and post-procedure infection, ranges from $849.24 per procedure at high-volume centers to $1,907.61 per procedure at low volume centers.

Changing the infection rate from 0.9% to 1.1% increased the cost per procedure by $97.19 at any volume. Decreasing it to 0.71 lowers the cost per procedure by $97.19 at all volumes, according to the research. Increasing the number of procedures per duodenoscope had “little to no impact” on lower volume centers. Only after the annual volume reached 250 did the price per procedure increase.