OBJECTIVES: Lung navigation platforms offer advanced approaches to improve the diagnostic yield of peripheral lung lesions. Two of these approaches are electromagnetic navigation bronchoscopy (ENB) and shape-sensing robotic-assisted bronchoscopy (ssRAB). As a recent publication has found the clinical and safety outcomes of ENB and ssRAB to not be statistically different, a cost-minimization analysis may help to inform the decision making of hospital providers regarding the ownership of ENB and ssRAB platforms.

METHODS: The costs of ownership were compared between one ENB (ILLUMISITE^TM fluoroscopic navigation platform) and one ssRAB (Ion^TM endoluminal system). Capital, procedure, and reprocessing costs were obtained from a teaching hospital in Louisiana and from list pricing. If no data was available, it was obtained from published literature, the IQVIA database, or industry data sources. Costs are presented in 2023 USD and considered over a 5-year time horizon.

RESULTS: Fixed costs including the capital system and the annual service plan differed among the platforms from $281,625 for ENB to $632,749 for ssRAB. Conversely, variable costs consisting of procedural, consumable, and reprocessing costs were comparable between the platforms, resulting in $2,077 (ENB) and $2,360 (ssRAB) per procedure. Considering a 5-year time horizon, ENB was found to have lower costs of ownership, saving $614,761 ($436,956-$757,118) compared to the ssRAB lung navigation platform.

CONCLUSIONS: Lower capital costs and similar operating costs make ENB technology a lower cost option compared to ssRAB. As list pricing is rarely the final price paid by the hospital for capital purchases, price offering options should be considered when making an ownership decision for a lung navigation platform. Since reimbursement is the same for ENB and ssRAB aided biopsy, the difference in acquisition, utilization and reprocessing costs should be an important factor for the ownership decision.