Cost comparison of oral, transnasal and magnet assisted capsule endoscopy in the examination of the upper gastrointestinal tract in patients with dyspepsia

• Published in: Frontline gastroenterology 2023-07, Vol.14 (4), p.300-305
• Main Authors: Tai, Foong Way David, Healy, Ailish, Thokala, Praveen, Chetcuti Zammit, Stefania, Sidhu, Reena, McAlindon, Mark
• Format: Article
• Language: English
• Subjects: Anesthesia; Biopsy; Costs; dyspepsia; Endoscopy; gastroscopy; Patients; Workforce planning
• ISSN: 2041-4137; 2041-4145
• DOI: 10.1136/flgastro-2022-102256

IntroductionConventional oral upper gastrointestinal (GI) endoscopy can obe uncomfortable. By comparison, transnasal endoscopy (TNE) and magnet assisted capsule endoscopy (MACE) have superior tolerability. A cost comparison of competing upper GI endoscopic modalities have yet to be performed.MethodsWe performed a cost comparison study of oral, TNE and MACE by a combination of activity-based costing and averaging of fixed costs over 24 481 upper GI endoscopies performed for dyspepsia over a 10-year period.ResultsOn average, 9.4 procedures were performed daily. TNE was cheapest at €125.90 per procedure, costing 30% less than oral endoscopy at €184.10 and threefold cheaper than MACE at €407.10. Flexible endoscope reprocessing cost €53.80. TNE was cheaper than oral endoscopy as sedation was not required. Oral endoscopies have a further rate of infectious complications, estimated to cost €16.20 per oral procedure in inpatient admissions. Oral and TNE equipment are more expensive to purchase and maintain than MACE costing €79 330 and €81 819, respectively compared with MACE at €15 420 per annum. However, capsule endoscopes cost significantly more per procedure at €369.00 than the consumables for flexible endoscopy (per oral €12.30, TNE €5.30).ConclusionsTNE cost less to perform than conventional per oral endoscopy. The cost of capsule endoscopes will need to be reduced significantly if routine use is to be expected.