Colonoscopy Preparation: Efficacy and Efficiency of Hospital-made Polyethylene Glycol (PEG) Compared with Commercial PEG

Abstract

Aim: Colorectal cancer is the third most deadly cancer worldwide, and colonoscopy is an effective method for screening for this cancer. Reducing the cost of colonoscopy could help increase adherence of patients with indications for this disease. The aim of this study was to compare the efficacy and cost-effectiveness for bowel clearance between hospital-made polyethylene glycol and the commercial product. Methods: A simple randomized double-blind study was conducted of 154 patients who underwent colonoscopy from August 2013 to November 2013. The patients were divided into two groups: group A (77 patients) received hospital-made polyethylene glycol prepared by the Pharmacy Department in Cipto Mangunkusumo National General Hospital, and group B (77 patients) received commercial product. The efficacy of bowel clearance in patients was assessed using Aronchick’s criteria. The cost-effectiveness was analyzed by comparing the costs between the two products. Results: The quality of bowel clearance did not differ between the two groups (P=0.997). In group A, bowel clearance was categorized as excellent in 32 patients (42%), good in 27 (35.1%), fair in 12 (15.6%), poor in five (6.5%), and inadequate in one (1.3%). In group B, the respective bowel clearance categorizations were 37 (48.1%), 22 (28.6%), 16 (20.8%), two (2.6%), and zero. The production costs per unit were equivalent to 1 United States Dollar for hospital-made polyethylene glycol and 18.2 United States Dollars for commercial product. Conclusions: The efficacy of bowel clearance did not differ between the two products. Hospital-made polyethylene glycol was more cost-effective than commercial product.