Reported prices for single-use flexible ureteroscopes varied by as much as fourfold across the countries represented in an international collaborative analysis, including within Europe. Romania, Belgium and Germany were listed among the lowest-cost countries, while Cyprus, Russia and the United States were among the highest. The results section described the global variation as significant, but the supplied account does not name the test used or give a p value or confidence interval.
At the centre of the comparison was the single-use flexible ureteroscope, referred to as FURS in the analysis. Its median reported price was €676.7. The interquartile range, or IQR, the span covering the middle half of reported prices, was €579 to €975. The observed range ran from €310 in Romania to €1,638 in Cyprus.
The cost of the equipment itself
Flexible and navigable access sheaths, abbreviated FANS, had a reported cost of €180, with an IQR of €130 to €226. Prices ranged from €36 to €400. The median per-procedure cost of FANS-assisted ureteroscopy, or URS, was €951.6, with reported values from €415 to €1,881.
These numbers describe acquisition prices, not patient results. The study asked how purchase and device-related costs for URS, FANS and FANS-assisted URS vary internationally. It compared countries and device categories in a compiled price dataset, and no patient data were collected.
How the comparison was made
The dataset covered 40 countries across Europe, Asia, North and South America, and the Middle East. Its reported unit was the country rather than a patient or clinical outcome. The results therefore provide country-level price benchmarks, rather than evidence about how the devices perform for patients.
To make the figures comparable, the researchers converted costs to euros, grouped countries into quartiles, and reported global medians with IQRs. The supplied analysis does not report how many observations came from each country, how countries were selected, when prices were collected, or how the currency conversion was done. It also does not identify device brands or models, procurement volumes, contract terms or taxes, details that could affect how directly one reported price can be compared with another.
A benchmark, not a verdict on value
That uncertainty is especially relevant to the report’s description of the variation as significant. The supplied analysis gives no named inferential test, p value, confidence interval or detailed country-level distribution. The reported up-to-fourfold gap should therefore be read as a description of the observed dataset, not as a precise estimate of what every health system would pay.
Nor do the figures show that healthcare policy or economic conditions caused the differences. The authors mention those factors while calling for cost-effectiveness analyses and evidence-based procurement policies. Their stated aim is to support more sustainable and equitable access, but this dataset does not establish clinical effectiveness, total procedure costs or value for money.
A reporting wrinkle
One reporting inconsistency also deserves attention. The data-availability statement says that no datasets were generated or analysed during the study, even though the methods and results describe a collaborative dataset of reported device prices. The supplied material does not explain the mismatch.
The article record lists receipt on 29 March 2026, acceptance on 01 August 2026, and publication as the version of record on 20 August 2026. The authors report no competing interests, and the funding section says no funding was used for the manuscript.
Paper data and sources
Original title: Global variation in acquisition costs of single-use flexible ureteroscopes and flexible navigable access sheaths: an international collaborative analysis from the YAU & EAU Endourology groups.
Authors: Amelia Pietropaolo, Hayder Alhusseinawi, Boyke Soebhali et al.
Journal/Repository: World journal of urology
Status: Peer-reviewed
First online: 2026-08-20
DOI: 10.1007/s00345-026-06668-8
Original paper · Full text