Vo l u m e 2 • S u m m e r 2 0 2 0
DDW 2020: Model Evaluates Cost, Infection Risk With Various Duodenoscopes
A
duodenoscope with a disposable endcap is the most cost-effective option to use in endoscopic retrograde cholangiopancreatography (ERCP), and it
is associated with a low rate of infection transmission, according to a modeling study presented at the Digestive Disease Week 2020 online meeting. The sttuuddy wa The w s co cond nduc nd uccte t d am amid idd ong n oiing ng coon nce cern rn ns abou ab ouut po pote t nttiiaal tr tran ansm sm mis issi sion on of in infe fect fe ctio ct ious io uss ageent ntss by duuoodden nossccoope pess th hat a has ledd to th he deve deeve velo lopm lo pmen pm en nt of n ve no vell du duodden noossco cope pees wi with t dis ispo ispo posa s bl sa blee en e dc dcap apss as ap welllll as fu we f llllyy ddiisp spos osab able ab bllee duoode d no nosc sccop opes e . In Aug es ugus ustt us 220019 1 , th he F FD DA reeco comm mmen ende en dedd tr de tran ansi an siti si tiion to us usee off suuch deevvic vic ices es and nd awa w y fr from om reu eusa sabl blee fi bl fixe xedd en xe endc dcap dc ap duuoodden enos osco os coope cope pess to redduc ucee or o elilimi mina mi nate t the nee te eedd fo forr r proces re esssi s ng of th thee de devi vice cess (b ( it it.l.ly/ y/2y 2y6I 6I1D 1Dh) h).. As of h) Apri Ap ril,l, fiv ivee pr prod oduc ucts ts wer eree ap appr prov oved ed tha hatt we were re eit ithe herr fuullllyy di disp sppos o ab able le orr ha hadd di disp spos osab able le com ompo pone nent ntss (s (see ee sidebar). Although there have been some reports of malfunctions with products with removable endcaps, the FDA “continues to recommend that hospitals and endoscopy facilities transition to innovative duodenoscope designs” to reduce the risk for infectious transmission (bit.ly/2y6I1Dh). Table.
Cost-Effectiveness of Duodenoscope-Transmitted Infection Minimization Strategies
Infection Control Approach
Cost-Effectiveness Ranking
Estimated Infection Transmission Rate, %
Estimated Cost Per Use,a $
Reusable Duodenoscopes Needed, n
Disposable endcap
1
0.1-1
654
5
Disposable duodenoscope
2
0
2,903
0
Culture and hold
3
0.1-2
387
12
Ethylene oxide
4
0.1-2
644
12
Single reprocessing
5
0.1-5
131
5
Double reprocessing
6
0.1-3
188
7
a
44
Includes materials and labor.
Endoscope Reprocessing & Infection Control
