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Age Dependent Cost-Effectiveness of Cochlear Implantation in Adults: Is There an Age Related Cut-off?


Laske, Roman D; Dreyfuss, Michael; Stulman, Alan; Veraguth, Dorothe; Huber, Alexander M; Röösli, Christof (2019). Age Dependent Cost-Effectiveness of Cochlear Implantation in Adults: Is There an Age Related Cut-off? Otology & Neurotology, 40(7):892-899.

Abstract

Objective: To analyze the impact of age at implantation on the cost-effectiveness of cochlear implantation (CI).
Study Design: Cost-utility analysis in an adapted Markov model.
Setting: Adults with profound postlingual hearing loss in a “high income” country.
Intervention: Unilateral and sequential CI were compared with hearing aids (HA).
Main Outcome Measure: Incremental cost-effectiveness ratio (ICER), calculated as costs per quality adjusted life year (QALY) gained (in CHF/QALY), for individual age and sex combinations in relation to two different willingness to pay thresholds. 1 CHF (Swiss franc) is equivalent to 1.01 USD.
Results: When a threshold of 50,000 CHF per QALY is applied, unilateral CI in comparison to HA is cost-effective up to an age of 91 for women and 89 for men. Sequential CI in comparison to HA is cost-effective up to an age of 87 for women and 85 for men. If a more contemporary threshold of 100,000 CHF per QALY is applied, sequential CI in comparison to unilateral CI is cost-effective up to an age of 80 for women and 78 for men.
Conclusions: Performing both sequential and unilateral CI is cost-effective up to very advanced ages when compared with hearing aids.

Abstract

Objective: To analyze the impact of age at implantation on the cost-effectiveness of cochlear implantation (CI).
Study Design: Cost-utility analysis in an adapted Markov model.
Setting: Adults with profound postlingual hearing loss in a “high income” country.
Intervention: Unilateral and sequential CI were compared with hearing aids (HA).
Main Outcome Measure: Incremental cost-effectiveness ratio (ICER), calculated as costs per quality adjusted life year (QALY) gained (in CHF/QALY), for individual age and sex combinations in relation to two different willingness to pay thresholds. 1 CHF (Swiss franc) is equivalent to 1.01 USD.
Results: When a threshold of 50,000 CHF per QALY is applied, unilateral CI in comparison to HA is cost-effective up to an age of 91 for women and 89 for men. Sequential CI in comparison to HA is cost-effective up to an age of 87 for women and 85 for men. If a more contemporary threshold of 100,000 CHF per QALY is applied, sequential CI in comparison to unilateral CI is cost-effective up to an age of 80 for women and 78 for men.
Conclusions: Performing both sequential and unilateral CI is cost-effective up to very advanced ages when compared with hearing aids.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Otorhinolaryngology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Otorhinolaryngology
Life Sciences > Sensory Systems
Health Sciences > Neurology (clinical)
Uncontrolled Keywords:Sensory Systems, Otorhinolaryngology, Clinical Neurology
Language:English
Date:1 August 2019
Deposited On:13 Jun 2019 14:54
Last Modified:20 Jan 2021 12:10
Publisher:Lippincott Williams & Wilkins
ISSN:1531-7129
OA Status:Green
Publisher DOI:https://doi.org/10.1097/mao.0000000000002275
PubMed ID:31157721

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