Early economic assessment of a medical device to enhance completion rates of difficult colonoscopies

Aims Colonoscopy is among the most frequently performed medical procedures globally. However, incomplete examinations due to difficulties in achieving caecal intubation are a common issue, leading to increased costs and delays in diagnosis and treatment. When a colonoscopy is incomplete, a second procedure, such as an additional optical colonoscopy or virtual colonoscopy, is typically recommended to ensure full exploration of the large bowel. A new medical device designed for standard colonoscopes has been developed to facilitate the completion of difficult colonoscopies. The study aimed to estimate the budget impact of introducing this medical device to manage colonoscopies deemed incomplete according to the “standard of care” (SoC) in the Italian clinical practice over a five-year period.

Methods A micro-costing analysis of the diagnostic procedure was performed from the hospital perspective. The National Healthcare System (NHS) perspective was considered by incorporating national reimbursement rates for healthcare services, along with costs associated with managing complications and potential diagnostic delays in patients with colon cancer. All cost estimates were adjusted to reflect 2024 values to account for inflation.

Results Increasing the use of the device from 2% to 10% of colonoscopies deemed incomplete according to the SoC over five years could result in savings of €633,449 from the hospital perspective and €856,286 from the NHS perspective. Cost savings are observed as early as the first year, primarily due to the avoidance of second procedures. Sensitivity analyses, which let all model parameters vary, indicated potential savings of up to €1,691,686 for the entire five-year period.

Conclusions Despite certain limitations due to the restricted patient care pathway and the lack of updated epidemiological data at national level, incorporating the medical device in the colonoscopies pathway could lead to significant cost savings from both the hospital and NHS perspectives. Further research is warranted to explore additional economic, organizational, and environmental benefits. Additionally, evaluating patient perspectives and preferences may identify further advantages of this technology.

Publication History

Article published online:
27 March 2025