Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels

Autores
Garay, Osvaldo Ulises; Garcia Elorrio, Ezequiel; Rodriguez, Viviana; Spira, Cintia; Augustovski, Federico Ariel; Pichón-Riviere, Andrés
Año de publicación
2017
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background Re-use of medical devices labeled and marketed for single use only is a current practice around the world. Objectives To estimate the average difference per surgery in device-related costs (DRCs) when performed with single-use devices under a single-use policy (SUP) instead of a re-use policy (RP) from the perspective of the private health sector of Argentina. Methods An analytical model was developed in Microsoft Excel and populated with data from a literature review, a Delphi-like panel, and local cost estimations. Four single-use devices were selected for analysis: plastic trocars, endocutters, linear cutters, and harmonic scalpels. DRCs were expressed in 2012 US dollars and divided into four cost categories: devices, adverse events, device failure, and surgical time extension. Outputs were expressed as DRCs per surgery under a SUP, under a RP, the difference between them expressed in US dollars (Diff_$), and the difference between them expressed as a percentage of surgery costs (Diff_%S). Deterministic and probabilistic sensitivity analyses were performed to analyze the impact of uncertainty on results. Results Expected DRCs per surgery were as follows: for trocars: SUP, US $424.6; RP, US $244.2; Diff_$ US $−180.4; and Diff_%S, −3.8%; for endocutters: SUP, US $1667.4; RP, US $1102.3; Diff_$ US $−565.1; and Diff_%S, −11.1%; for linear cutters: SUP, US $1228.1; RP, US $1045.9; Diff_$ US $−182.2; and Diff_%S, −3.4%; and for harmonic scalpels: SUP, US $1040.9; RP, US $292.4; Diff_$ US $−748.5; and Diff_%S, −14.8%. Sensitivity analyses showed results to be robust. Conclusions RP was shown to be less costly in all devices and scenarios considered. Nevertheless, the real frequency of adverse events and their cost implications are still uncertain. More research is needed to assess the effectiveness and safety of these off-label policies.
Fil: Garay, Osvaldo Ulises. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Spira, Cintia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pichón-Riviere, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Materia
Costs And Cost Analysis
Equipment Re-Use
Medical Devices
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/66273
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/66273
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic ScalpelsGaray, Osvaldo UlisesGarcia Elorrio, EzequielRodriguez, VivianaSpira, CintiaAugustovski, Federico ArielPichón-Riviere, AndrésCosts And Cost AnalysisEquipment Re-UseMedical Deviceshttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background Re-use of medical devices labeled and marketed for single use only is a current practice around the world. Objectives To estimate the average difference per surgery in device-related costs (DRCs) when performed with single-use devices under a single-use policy (SUP) instead of a re-use policy (RP) from the perspective of the private health sector of Argentina. Methods An analytical model was developed in Microsoft Excel and populated with data from a literature review, a Delphi-like panel, and local cost estimations. Four single-use devices were selected for analysis: plastic trocars, endocutters, linear cutters, and harmonic scalpels. DRCs were expressed in 2012 US dollars and divided into four cost categories: devices, adverse events, device failure, and surgical time extension. Outputs were expressed as DRCs per surgery under a SUP, under a RP, the difference between them expressed in US dollars (Diff_$), and the difference between them expressed as a percentage of surgery costs (Diff_%S). Deterministic and probabilistic sensitivity analyses were performed to analyze the impact of uncertainty on results. Results Expected DRCs per surgery were as follows: for trocars: SUP, US $424.6; RP, US $244.2; Diff_$ US $−180.4; and Diff_%S, −3.8%; for endocutters: SUP, US $1667.4; RP, US $1102.3; Diff_$ US $−565.1; and Diff_%S, −11.1%; for linear cutters: SUP, US $1228.1; RP, US $1045.9; Diff_$ US $−182.2; and Diff_%S, −3.4%; and for harmonic scalpels: SUP, US $1040.9; RP, US $292.4; Diff_$ US $−748.5; and Diff_%S, −14.8%. Sensitivity analyses showed results to be robust. Conclusions RP was shown to be less costly in all devices and scenarios considered. Nevertheless, the real frequency of adverse events and their cost implications are still uncertain. More research is needed to assess the effectiveness and safety of these off-label policies.Fil: Garay, Osvaldo Ulises. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Spira, Cintia. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Pichón-Riviere, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaElsevier Inc2017-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/66273Garay, Osvaldo Ulises; Garcia Elorrio, Ezequiel; Rodriguez, Viviana; Spira, Cintia; Augustovski, Federico Ariel; et al.; Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels; Elsevier Inc; Value in Health Regional Issues; 14; 12-2017; 89-952212-1099CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/http://linkinghub.elsevier.com/retrieve/pii/S2212109917300651info:eu-repo/semantics/altIdentifier/doi/10.1016/j.vhri.2017.04.005info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-10-22T11:31:53Zoai:ri.conicet.gov.ar:11336/66273instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-10-22 11:31:53.663CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
title Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
spellingShingle Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
Garay, Osvaldo Ulises
Costs And Cost Analysis
Equipment Re-Use
Medical Devices
title_short Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
title_full Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
title_fullStr Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
title_full_unstemmed Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
title_sort Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels
dc.creator.none.fl_str_mv Garay, Osvaldo Ulises
Garcia Elorrio, Ezequiel
Rodriguez, Viviana
Spira, Cintia
Augustovski, Federico Ariel
Pichón-Riviere, Andrés
author Garay, Osvaldo Ulises
author_facet Garay, Osvaldo Ulises
Garcia Elorrio, Ezequiel
Rodriguez, Viviana
Spira, Cintia
Augustovski, Federico Ariel
Pichón-Riviere, Andrés
author_role author
author2 Garcia Elorrio, Ezequiel
Rodriguez, Viviana
Spira, Cintia
Augustovski, Federico Ariel
Pichón-Riviere, Andrés
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Costs And Cost Analysis
Equipment Re-Use
Medical Devices
topic Costs And Cost Analysis
Equipment Re-Use
Medical Devices
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background Re-use of medical devices labeled and marketed for single use only is a current practice around the world. Objectives To estimate the average difference per surgery in device-related costs (DRCs) when performed with single-use devices under a single-use policy (SUP) instead of a re-use policy (RP) from the perspective of the private health sector of Argentina. Methods An analytical model was developed in Microsoft Excel and populated with data from a literature review, a Delphi-like panel, and local cost estimations. Four single-use devices were selected for analysis: plastic trocars, endocutters, linear cutters, and harmonic scalpels. DRCs were expressed in 2012 US dollars and divided into four cost categories: devices, adverse events, device failure, and surgical time extension. Outputs were expressed as DRCs per surgery under a SUP, under a RP, the difference between them expressed in US dollars (Diff_$), and the difference between them expressed as a percentage of surgery costs (Diff_%S). Deterministic and probabilistic sensitivity analyses were performed to analyze the impact of uncertainty on results. Results Expected DRCs per surgery were as follows: for trocars: SUP, US $424.6; RP, US $244.2; Diff_$ US $−180.4; and Diff_%S, −3.8%; for endocutters: SUP, US $1667.4; RP, US $1102.3; Diff_$ US $−565.1; and Diff_%S, −11.1%; for linear cutters: SUP, US $1228.1; RP, US $1045.9; Diff_$ US $−182.2; and Diff_%S, −3.4%; and for harmonic scalpels: SUP, US $1040.9; RP, US $292.4; Diff_$ US $−748.5; and Diff_%S, −14.8%. Sensitivity analyses showed results to be robust. Conclusions RP was shown to be less costly in all devices and scenarios considered. Nevertheless, the real frequency of adverse events and their cost implications are still uncertain. More research is needed to assess the effectiveness and safety of these off-label policies.
Fil: Garay, Osvaldo Ulises. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Garcia Elorrio, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Rodriguez, Viviana. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Spira, Cintia. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Augustovski, Federico Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Pichón-Riviere, Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
description Background Re-use of medical devices labeled and marketed for single use only is a current practice around the world. Objectives To estimate the average difference per surgery in device-related costs (DRCs) when performed with single-use devices under a single-use policy (SUP) instead of a re-use policy (RP) from the perspective of the private health sector of Argentina. Methods An analytical model was developed in Microsoft Excel and populated with data from a literature review, a Delphi-like panel, and local cost estimations. Four single-use devices were selected for analysis: plastic trocars, endocutters, linear cutters, and harmonic scalpels. DRCs were expressed in 2012 US dollars and divided into four cost categories: devices, adverse events, device failure, and surgical time extension. Outputs were expressed as DRCs per surgery under a SUP, under a RP, the difference between them expressed in US dollars (Diff_$), and the difference between them expressed as a percentage of surgery costs (Diff_%S). Deterministic and probabilistic sensitivity analyses were performed to analyze the impact of uncertainty on results. Results Expected DRCs per surgery were as follows: for trocars: SUP, US $424.6; RP, US $244.2; Diff_$ US $−180.4; and Diff_%S, −3.8%; for endocutters: SUP, US $1667.4; RP, US $1102.3; Diff_$ US $−565.1; and Diff_%S, −11.1%; for linear cutters: SUP, US $1228.1; RP, US $1045.9; Diff_$ US $−182.2; and Diff_%S, −3.4%; and for harmonic scalpels: SUP, US $1040.9; RP, US $292.4; Diff_$ US $−748.5; and Diff_%S, −14.8%. Sensitivity analyses showed results to be robust. Conclusions RP was shown to be less costly in all devices and scenarios considered. Nevertheless, the real frequency of adverse events and their cost implications are still uncertain. More research is needed to assess the effectiveness and safety of these off-label policies.
publishDate 2017
dc.date.none.fl_str_mv 2017-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/66273
Garay, Osvaldo Ulises; Garcia Elorrio, Ezequiel; Rodriguez, Viviana; Spira, Cintia; Augustovski, Federico Ariel; et al.; Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels; Elsevier Inc; Value in Health Regional Issues; 14; 12-2017; 89-95
2212-1099
CONICET Digital
CONICET
url http://hdl.handle.net/11336/66273
identifier_str_mv Garay, Osvaldo Ulises; Garcia Elorrio, Ezequiel; Rodriguez, Viviana; Spira, Cintia; Augustovski, Federico Ariel; et al.; Single-Use Devices in Argentina: Cost Comparison Analysis of a “Re-Use” versus a “Single-Use” Policy for Trocars, Endocutters, Linear Cutters, and Harmonic Scalpels; Elsevier Inc; Value in Health Regional Issues; 14; 12-2017; 89-95
2212-1099
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://linkinghub.elsevier.com/retrieve/pii/S2212109917300651
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.vhri.2017.04.005
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Inc
publisher.none.fl_str_mv Elsevier Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 12.982451

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