The Reuse of Medical Devices Intended for Single Use Only in the United Kingdom
Putnam, Jonathan D.
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The issue of reusing medical devices intended for single use only has become increasingly popular in the United Kingdom. In an effort to create some written work to accompany the concerns of Stryker UK, the marketing team embarked on an information gathering project regarding the dilemma. The result was a compelling packet of information for the Stryker UK sales force, to be discussed with hospitals in their area. My role was to gather as much information and background as possible, including the views of a local theatre manager, for a paper which would advocate the termination of the practice of reuse. The general nature of this paper, then, is to establish the corresponding issues, be they price or non-price, and organize them in a manner which will compel the reader to agree with the single use only principle. It is important to keep in mind that this paper presents an argument against reuse. The opinions of both sides are explained, and conclusions are drawn based on all the information included. The discussion begins by giving some background into the nature of the problem. It is clear that cost is the major issue with public hospitals in the United Kingdom, and this is the premise for the practice of reuse. To gain some insight as to why Britain's National Health Service has moved to undertake reusing medical devices, some background about the NHS itself is given. Included in this section is the information regarding NHS reforms, which have resulted in dis-jointed budget systems and incentive-less economic actions. Some reasons are also given regarding the increasing cost of health care, as this is essential to understanding the nature of the problem. The paper then moves into the issues surrounding this debate. Patient safety, surgical effectiveness, shifting liability, and ethical considerations all play a part in this debate, and each is examined closely. For the most part, these issues present reasons why the practice of reuse should be terminated. In an effort to examine both sides of the debate, the discussion then moves to the issue of cost-effectiveness. Next, externalities and optimality are discussed, keeping in mind both the information on cost-effectiveness and non-price factors. Finally, in an attempt to view the non-price and price issues from the perspective of a health care provider, the opinions of a local theatre nurse are given. It is concluded that the best option in the long-run is to end the practice of reusing such medical devices. Based on the supporting information, it is apparent that none of the non-price issues favor reuse, and most are compelling reasons against it altogether. In addition, the cost analysis does not make for a moving argument, especially when the costs initially unrealized are considered. The fmal conclusions are based on what is best for the marketplace and for society. The cost may ultimately be less for hospitals, meaning there would absolutely no reason for reuse. Even if some cost-benefit remains, the non-price factors are heavily against continuing the practice of reuse.