When considering device reimbursement, single-use duodenoscopes may be a viable financial option for low-volume centers and possibly efficient high-volume facilities as well.

That conclusion was drawn by researchers who presented a poster during ACG 2023.

The poster’s authors write that estimates of an economic “break-even” point for single-use scopes used during endoscopic retrograde cholangiopancreatography (ERCP) are between 150 and 250 procedures per year and assuming a 0.4 percent infection rate without factoring in device reimbursement. The group aimed to identify the impact of single-use duodenoscopes for ERCP relating to recent reimbursement schedules.

“Duodenoscope-associated bacterial infections have been identified by the [U.S. Food and Drug Administration] as a cause of morbidity and mortality for patients undergoing ERCP,” the poster begins. “A solution to the concern for device-transmitted infections is the development of sterile, single-use duodenoscopes (SUD).”

The authors identify three possible benefits of these devices:

• Lack of initial capital investment
• Absence of reprocessing and instrument maintenance
• Elimination of potential institutional costs of infection-related complications

For this study, 155 ERCP procedures were completed between Jan. 1, 2022 and April 20, 2023. Of these, 68 outpatient cases were included and 55 received reimbursement. The average reimbursement was $3,985 per case, bringing the total average when including the non-reimbursed cases to $3,223. Device costs totaled $2,930 per case, resulting in a “net impact margin” of $293.16 per case.