Sedasys cost much less per-case than an anesthesia professional —
$150 to $200 versus $600 up to $2,000 for an anesthesia provider —
how colonoscopies are reimbursed meant that the facility didn't
always see the savings. Dr. Noback says that typically a GI provider
and facility receive a bundled payment that covers the procedure, as
well as costs associated with any anesthesia equipment, supplies and
drugs. If an anesthesia provider is brought in to administer propofol,
he receives a separate professional fee. With Sedasys, nobody quali-
fied for the separate professional fee, and its higher disposables cost
cut into the facility's bundled reimbursement for the procedure. So in
theory, facilities could pay up to $200,000 for a machine with limited
use and have higher per-case costs — without receiving any additional
reimbursement.
Where do we go from here?
Of the 4 facilities that participated in the initial Sedasys rollout, 2 we
talked to say they're disappointed that the technology will no longer be
available. A ProMedica Toledo (Ohio) Hospital spokesperson says they
hope J&J or another company markets the technology in the future.
Andrew Ross, MD, section head of gastroenterology at Virginia Mason
Medical Center in Seattle, Wash., says that in discussions with the compa-
ny, they learned "that the decision was driven purely by economics." He
says that the hospital found increased efficiency and patient satisfaction
after its use in more than 8,000 procedures. "In light of these and other
significant benefits, it's difficult to believe this technology would have no
future in medicine," he says.
Both Rhode Island Hospital and Loma Linda's Dr. Volk declined to
comment further on Ethicon's announcement.
Dr. Apfelbaum says that despite anesthesia's initial hesitance about
the machine, he was also disappointed when he heard the news.
A P R I L 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 9
