Cost saving

To assess the total cost of using single-use disposables in favour of re-usable instruments, procurement personnel need to take into consideration more than initial purchasing cost.

The best way to illustrate these cost differences is by looking at the varying processes reusable and single-use instruments go through in order to be fit-for-purpose.

A reusable instrument is used on a patient; it must then be reprocessed – cleaned and decontaminated – before it can be used on another patient.

For many hospitals their reprocessing is done off site in remote locations, and then sent back.

The table compares the potential costs.

Reusable	Single-use
Initial purchasing costs	Purchasing costs - buy in bulk = economies of scale
Cost of transport to off site location	None
Cost of man power to reprocess the instrument	None
Cost of transport back	None
Cost of reprocessing resources - energy to make steam, use of chemicals, use of machinery	None
Cost of staff used to arrange for reprocessing to take place - collection and reassembling of instruments.	None

Research collected via DTR Medical’s clinical consultations show that costs of reprocessing vary. Some reusable instruments can cost as little as £1 to reprocess, however their disposable equivalent also costs £1, so the question put to clinicians is: why take the risks with cross-contamination and potential time delays if there is no differentiation in price? As a comparison, other more specialised instruments used by private hospitals can cost as much as £9.

There are other less tangible costs that are not always realised, but very important when discussing cost savings:

No repairs are needed with single-use, something that occurs regularly with reusable instruments to keep them sharp, straight and ‘fit for purpose’. The typical cost of repair for an instrument is £50. Replacement can often be more cost effective than repair, but this raises costs. Single-use rules out these problems.
Expensive and fine precision instruments are at greatest risk of damage, and where financial losses are the highest
Busy clinical units need multiple sets of instruments to cope with high patient numbers which can put pressure on capital costs of new re-usable equipment
Reusable instruments can put patients at risk of healthcare-acquired infections (HCAIs), such as surgical site infections (SSI). An SSI may present as a relatively trivial and spontaneously limited wound discharge, for example 8-9 days after an operation, or as a life-threatening postoperative complication. Patients’ well-being aside, these infections have huge cost implications on NHS Trusts as patients can spend up to 14 extra days in hospital
Disposing of instruments after one use may seem a waste of resources but compared to the costs associated with reusable products, the cost-saving speaks for itself.

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