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Original research
Cost comparison of oral, transnasal and magnet assisted capsule endoscopy in the examination of the upper gastrointestinal tract in patients with dyspepsia
  1. Foong Way David Tai1,
  2. Ailish Healy1,
  3. Praveen Thokala2,
  4. Stefania Chetcuti Zammit3,
  5. Reena Sidhu1,
  6. Mark McAlindon1
  1. 1 Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield, UK
  2. 2 Health Economics and Decision Science, The University of Sheffield School of Health and Related Research, Sheffield, UK
  3. 3 Gastroenterology, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Foong Way David Tai, Academic Unit of Gastroenterology and Hepatology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK; david.tai{at}


Introduction Conventional oral upper gastrointestinal (GI) endoscopy can obe uncomfortable. By comparison, transnasal endoscopy (TNE) and magnet assisted capsule endoscopy (MACE) have superior tolerability. A cost comparison of competing upper GI endoscopic modalities have yet to be performed.

Methods We performed a cost comparison study of oral, TNE and MACE by a combination of activity-based costing and averaging of fixed costs over 24 481 upper GI endoscopies performed for dyspepsia over a 10-year period.

Results On average, 9.4 procedures were performed daily. TNE was cheapest at €125.90 per procedure, costing 30% less than oral endoscopy at €184.10 and threefold cheaper than MACE at €407.10. Flexible endoscope reprocessing cost €53.80. TNE was cheaper than oral endoscopy as sedation was not required. Oral endoscopies have a further rate of infectious complications, estimated to cost €16.20 per oral procedure in inpatient admissions. Oral and TNE equipment are more expensive to purchase and maintain than MACE costing €79 330 and €81 819, respectively compared with MACE at €15 420 per annum. However, capsule endoscopes cost significantly more per procedure at €369.00 than the consumables for flexible endoscopy (per oral €12.30, TNE €5.30).

Conclusions TNE cost less to perform than conventional per oral endoscopy. The cost of capsule endoscopes will need to be reduced significantly if routine use is to be expected.

  • gastroscopy
  • dyspepsia

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors FWDT performed analyses, prepared, wrote the manuscript. PT performed analyses and contributed to the editing and revision; AH, SCZ, RS and MM contributed to the first draft, editing and revision of the manuscript. FWDT is the guarantor of the article.

  • Funding This study has been supported by AnX Robotica (Texas, USA) in the provision of capsule endoscopes and travel expenses for FWDT and MM to receive training in the use of the system; and the Dawkins and Strutt British Medical Association grant for salary support of FWDT.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.