Cost Effectiveness of the Multichannel Cochlear Implant

Author(s): Niparko, J. K., Rothman, M. L., Delissovoy, G.

Journal/Book: Amer J Otology. 1995; 16: One James Street South, PO Box 620, LCD 1, Hamilton on L8N 3K7, Canada. Decker Periodicals Inc. 52-62.

Abstract: Although most third-party payors presently fund cochlear implantation, some do not, and many cite the current lack of cost-effectiveness data as a major concern. Cost-utility analysis is a widely used method of medical technology assessment that permits cost-effectiveness comparisons between medical interventions by determining the cost per quality-adjusted life-year (QALY) they provide. The cost per QALY for the cochlear implant was determined using clinical cost data and a health-utility outcome model based on the established communication gains attained with the device. Cochlear implantation costs approximately $15,600 per QALY provided. Sensitivity analysis, a technique that systematically varies the assumptions underlying the calculations, suggests a range for the true value of between $12,000 and $30,000. This compares favorably with other medical interventions, such as coronary artery bypass grafting ($10,431 for three-vessel disease, $64,033 for single-vessel disease), the implantable defibrillator ($29,200), and cardiac transplanation ($38,970). This analysis indicates that the cochlear implant lies well within the cost-effectiveness range currently accepted by the American medical system.

Note: Article JR Wyatt, Johns Hopkins Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, POB 41402, Baltimore, MD 21203 USA

Keyword(s): HEARING-AIDS; CHILDREN; LIFE; REHABILITATION; DEFIBRILLATOR; REPLACEMENT; TECHNOLOGY; ADOPTION; QUALITY; SYSTEM

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