Cost-minimization analysis of jumbo reusable forceps versus disposable forceps in a high-volume ambulatory endoscopy center.

ABSTRACT

BACKGROUND: Endoscopists worldwide are faced with the challenge of choosing the most cost-effective and durable equipment. There are limited data comparing the 2 major options for endoscopic forceps disposable and reusable. Disposable forceps are marketed as the cost-effective alternative to reusable forceps. OBJECTIVE: This study was designed to provide a prospective assessment of the survival and cost of reusable versus disposable forceps to allow more educated decisions when purchasing endoscopic equipment. DESIGN: A 24-month prospective study in a high-volume ambulatory endoscopy center (AEC) with 71 Olympus jumbo reusable forceps (OJRF). A "cost of OJRF per procedure" was generated to compare to the estimated cost of disposable forceps per procedure. SETTING: Gastrointestinal Associates PA of Jackson, Mississippi, which performs approximately 24,000 outpatient procedures per year. PATIENTS General patient population of this AEC undergoing colonoscopy. MAIN OUTCOME MEASUREMENTS Mean cost of forceps per procedure and survival of reusable forceps. Cost was derived from purchase price, cleaning costs, repair/maintenance costs, and number of uses. RESULTS: Over the 24-month period, the total cost per procedure was $3.27. The mean number of uses per OJRF was 166.3. Sixty-eight percent of the forceps required no repair throughout the 2-year study, and only 1 forceps was deemed beyond repair. For comparison, disposable forceps were assigned a cost per procedure of $10.00 on the basis of conservative market price. Over a 2-year period this cost-per-procedure difference resulted in a cost savings of $79,482. LIMITATIONS: Failure to determine the average life-span of OJRF because 98% were still functioning properly after 2 years and an average of 166.3 procedures. Evaluation did not include storage and disposal costs, which would add a miniscule additional cost to disposable costs. The study also does not address some of the other arguments for disposables such as performance (quality of specimen) compared with reusables. The estimated average number of uses and durability was only studied for the OJRF. Other forceps may have different average cost per use and durability. CONCLUSIONS: In a large-volume AEC, OJRF are vastly more durable than resusable forceps reported in prior studies and are vastly more cost-effective than disposable forceps. A longer study period would have only revealed more dramatic cost savings and durability.