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Otol Neurotol. 2019 Aug;40(7):892-899. doi: 10.1097/MAO.0000000000002275.

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

Author information

1
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich.
2
University of Zurich, Zurich, Switzerland.
3
Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel.

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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