Cost comparison of re‐usable and single‐use fibrescopes in a large English teaching hospital

Summary A number of studies in the USA and mainland Europe have described the costs of fibreoptic tracheal intubation. However, no such data from the UK appear available. We performed a cost assessment of fibreoptic intubation, using re‐usable (various devices from Olympus, Acutronic and Karl Storz) and single‐use (Ambu® aScope™) fibrescopes, at the Queens Medical Centre, Nottingham, UK, between 1 January 2009 and 31 March 2014. The total annual cost of fibreoptic intubation with re‐usable fibrescopes was £46 385. Based on 141 fibreoptic intubations per year, this equated to £329 per use, an average dominated by repair/maintenance costs (43%) and capital depreciation costs (42%). In comparison, the total annual cost of using single‐use fibrescopes for the same work would have been around £200 per use. The analysis enabled us to develop a generic model, wherein we were able to describe the relationship between total cost of use vs number of uses for a fibrescope. An ‘isopleth’ was identified for this relationship: a line that joined all the points where the cost of re‐usable vs single‐use fibrescopes was equal. It appears cheaper to use single‐use fibrescopes at up to 200 fibreoptic intubations per year (a range commensurate with normal practice) even when the repair rate for re‐usable fibrescopes is low. Any centre, knowing its fibrescope use and repair rate, can plot its data similarly to help ascertain which of the re‐usable or single‐use fibrescope represents better value.