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Publications

Journal Article Epublish

PubMed: 42625061 DOI: 10.1007/s00345-026-06668-8

Global variation in acquisition costs of single-use flexible ureteroscopes and flexible navigable access sheaths: an international collaborative analysis from the YAU & EAU Endourology groups.

World J Urol 44(1)

Authors: Amelia Pietropaolo, Hayder Alhusseinawi, Boyke Soebhali, Johan Cabrera, Azimdjon Tursunkulov, Deepak Ragoori, Fabio C Vincentini, Gaston M Astroza, Kremena Petkova, Cho Sung Yong, Niall Davis, Christopher Netsch, Benedikt Becker, Chu Ann Chai, Frederic Panthier, Chinnakhet Ketsuwan, Otas Durutovic, Catalina Solano, Nariman Gadzhiev, Naeem Bhojani, Stavros Gravas, Bogdan Geavlete, Ahmed Said Zribi, Peter Kronenberg, David Lifshitz, Helene Jung, Vineet Gauhar, Steffi Kar Kei Yuen, Felipe Pauchard, Arman Tsaturyan, Eugenio Ventimiglia, Lazaros Tzelves, Begona Ballesta Martinez, Rifat Burak Ergül, Tarik Emre Sener, Łukasz Nowak, Thomas Tailly, Matthias Boeykens, Alba Sierra, Ali Talyshinskii, Etienne Xavier Keller, Francesco Esperto, Alberto Olivero, Ioannis Mykoniatis, Victoria Jahrreiss, Patrick Juliebø-Jones, Saeed Bin Hamri, Pablo Contreras, Juliana Alvarez, Maria Florencia Frascheri … and 1 other author

Affiliations

  • Urology, University Hospital Southampton, Southampton, UK.
  • EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group Arnhem, Arnhem, The Netherlands.
  • Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.
  • Department of Urology, North Denmark Regional Hospital, Hjørring, Denmark.
  • Department of Urology, Abdoel Wahab Sjahranie Hospital Samarinda, Samarinda, Indonesia.
  • Hospital Guillermo Almenara, Lima, Peru.
  • Urology Department, School of Medicine Central, Asian University, Akfamedline University Hospital, Tashkent, Uzbekistan.
  • Asian Institute of Nephrology and Urology, HITEC City, AINU Hospital, Hyderabad, India.
  • Einstein Hospital Israelita, São Paulo, Brazil.
  • Hospital das Clinicas da FMUSP, University of São Paulo Medical School, São Paulo, Brazil.
  • Urology Department, Pontificia Universidad Católica de Chile, Santiago, Chile.
  • Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria.
  • Department of Urology, Seoul National University Hospital, Seoul, South Korea.
  • Department of Urology, Blackrock Clinic, Dublin, Ireland.
  • Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
  • Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany.
  • Urology Unit, Department of Surgery, University Malaya, Kuala Lumpur, Malaysia.
  • GRC 20-Endolase LAB, APHP, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
  • Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.
  • PIMM, UMR 8006 CNRS-Arts et Métiers ParisTech, 151 Bd de L'Hôpital, 75013, Paris, France.
  • Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Salaya, Thailand.
  • Division of Endourology, University Clinical Center of Serbia, Belgrade, Serbia.
  • Department of Urology, Uroclin Clinic, Medellín, Colombia.
  • Saint Petersburg State University Hospital, St. Petersburg, Russia.
  • University of Montreal Health Center, Montreal, Canada.
  • Urology, General Hospital of Nicosia, Strovolos, Cyprus.
  • Urology, Saint John Hospital, Bucharest, Romania.
  • University of Medicine, Tunisi, Tunisia.
  • CUF Hospital Group, Lisbon, Portugal.
  • Department of Urology, Rabin Medical Center, Petah Tikva, Israel.
  • Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
  • Hospital Lillebaelt, Vejle, Denmark.
  • Ng Teng General Hospital, Singapore, Singapore.
  • Asian Institute of Nephrology and Urology (AINU), Chennai, India.
  • Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China.
  • Urology Institute, University Hospitals, Cleveland, USA.
  • EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group Arnhem, Arnhem, The Netherlands.
  • Erebuni Medical Center, Yerevan, Armenia.
  • Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
  • Urology, National and Kapodistrian University of Athens, Athens, Greece.
  • Hospital Universitario del Vinalopó, Elche, Alicante, Spain.
  • Department of Urology, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
  • Urology, Marmara University School of Medicine, Istanbul, Turkey.
  • Department of Minimally Invasive and Robotic Urology, University Centre of Excellence in Urology, Wroclaw Medical University, Wroclaw, Poland.
  • University Hospital Ghent, Ghent, Belgium.
  • Department of Urology, Hospital Clinic de Barcelona, Barcelona, Spain.
  • Astana Medical University, Astana, Kazakhstan.
  • University Hospital Zurich, Zurich, Switzerland.
  • Campus Biomedico University, Rome, Italy.
  • ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Aristotle University of Thessaloniki, Thessaloníki, Greece.
  • Medical University of Vienna, Vienna, Austria.
  • Haukeland University Hospital, Bergen, Norway.
  • Smc Hospitals, Riyadh, Saudi Arabia.
  • Department of Urology, Hospital Aleman Buenos Aires, Buenos Aires, Argentina.
  • Urology, University Hospital Southampton, Southampton, UK.

Abstract

BACKGROUND AND OBJECTIVE

Endourological practice increasingly depends on single-use devices, whose costs vary considerably across regions and health care systems. Flexible single use ureteroscopes (URS) and flexible and navigable sheaths (FANS) represent a major component of ureteroscopy-related expenditure. This study aimed to evaluate international variation in purchase and device-related acquisition cost of URS, FANS, and the cost of FANS (suction) assisted URS (URS and FANS).

METHODS

An international collaborative dataset compiled by the EAU Endourology Group collected information on device purchase prices for single use flexible ureteroscopes, FANS, and suction assisted URS across multiple countries. All costs were converted to Euros (€). Countries were stratified into quartiles, and global medians with interquartile ranges (IQRs) were reported.

RESULTS

Data were obtained from 40 countries across Europe, Asia, North and South America, and the Middle East, and showed a significant global cost variation. The median price of single-use FURS was €676.7 (IQR 579-975), ranging from €310 (Romania) to €1638 (Cyprus), while FANS cost €180 (IQR 130-226), ranging from €36 to €400. Median per-procedure FANS assisted URS cost was €951.6 (range €415-1881). Lowest costs were observed in Romania, Belgium, and Germany, while highest were in Cyprus, Russia, and the United States, with up to four-fold inter-country variation, including within Europe.

CONCLUSIONS

Substantial global variability exists in the cost of URS and FANS, influenced by healthcare policy, and economic conditions. These findings highlight the need for cost-effectiveness analyses and the development of evidence-based procurement policies to promote sustainability and equitable access in endourological practice.

MeSH

Ureteroscopes, Urology, Suction