The Cost of Clipping-How Much Does Price Matter?

Clip closure is effective for large (>= 20 mm) nonpedunculated polyps in the proximal colon. The cost-effectiveness analysis by Albeniz et al. found that selective clipping of polyps at a minimum risk (>13% in the United States, >10% in Spain) is worthwhile clipping. Although such model is theoretically sound, clinical practice should be primarily guided by efficacy data. Moreover, the analysis is very sensitive to the high price of clips, which is likely to reduce in the foreseeable future.