Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial

Yvette E Smulders; Alice van Zon; Inge Stegeman; Gijsbert A van Zanten; Albert B Rinia; Robert J Stokroos; Rolien H Free; Bert Maat; Johan H M Frijns; Emmanuel A M Mylanus; Wendy J Huinck; Vedat Topsakal; Wilko Grolman

doi:10.1097/MAO.0000000000000901

Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial

Yvette E Smulders
, Alice van Zon
, Inge Stegeman
, Gijsbert A van Zanten
, Albert B Rinia
, Robert J Stokroos
, Rolien H Free
, Bert Maat
, Johan H M Frijns
, Emmanuel A M Mylanus
, Wendy J Huinck
, Vedat Topsakal
, Wilko Grolman

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI.

STUDY DESIGN: Randomized controlled trial (RCT).

SETTING: Five tertiary referral centers.

PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.

INTERVENTIONS: A cost-utility analysis was performed from a health insurance perspective.

MAIN OUTCOME MEASURES: Utility was assessed using the HUI3, TTO, VAS on hearing, VAS on general health and EQ-5D. We modeled the incremental cost per quality-adjusted life year (QALY) of unilateral versus bilateral CI over periods of 2, 5, 10, 25 years, and actual life-expectancy.

RESULTS: Direct costs for unilateral and bilateral CI were &OV0556;43,883 ± &OV0556;11,513(SD) and &OV0556;87,765 ± &OV0556;23,027(SD) respectively. Annual costs from the second year onward were &OV0556;3,435 ± &OV0556;1,085(SD) and &OV0556;6,871 ± &OV0556;2,169(SD), respectively. A cost-utility analysis revealed that a second implant became cost-effective after a 5- to 10-year period, based on the HUI3, TTO, and VAS on hearing.

CONCLUSION: This is the first study that describes a cost-utility analysis to compare unilateral with simultaneous bilateral CI in postlingually deafened adults, using a multicenter RCT. Compared with accepted societal willingness-to-pay thresholds, simultaneous bilateral CI is a cost-effective treatment for patients with a life expectancy of 5-10 years or longer.

Original language	English
Pages (from-to)	38-45
Number of pages	8
Journal	Otology & Neurotology
Volume	37
Issue number	1
DOIs	https://doi.org/10.1097/MAO.0000000000000901
Publication status	Published - Jan 2016

Keywords

Bilateral cochlear implantation
Cochlear implant
Cost-effectiveness
Cost-utility
Deafness
Hearing loss

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10.1097/MAO.0000000000000901

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Smulders, Y. E., van Zon, A., Stegeman, I., van Zanten, G. A., Rinia, A. B., Stokroos, R. J., Free, R. H., Maat, B., Frijns, J. H. M., Mylanus, E. A. M., Huinck, W. J., Topsakal, V., & Grolman, W. (2016). Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial. Otology & Neurotology, 37(1), 38-45. https://doi.org/10.1097/MAO.0000000000000901

@article{3a699c26add943798c3f22bfe1a8534e,

title = "Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial",

abstract = "OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI.STUDY DESIGN: Randomized controlled trial (RCT).SETTING: Five tertiary referral centers.PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.INTERVENTIONS: A cost-utility analysis was performed from a health insurance perspective.MAIN OUTCOME MEASURES: Utility was assessed using the HUI3, TTO, VAS on hearing, VAS on general health and EQ-5D. We modeled the incremental cost per quality-adjusted life year (QALY) of unilateral versus bilateral CI over periods of 2, 5, 10, 25 years, and actual life-expectancy.RESULTS: Direct costs for unilateral and bilateral CI were \&OV0556;43,883 ± \&OV0556;11,513(SD) and \&OV0556;87,765 ± \&OV0556;23,027(SD) respectively. Annual costs from the second year onward were \&OV0556;3,435 ± \&OV0556;1,085(SD) and \&OV0556;6,871 ± \&OV0556;2,169(SD), respectively. A cost-utility analysis revealed that a second implant became cost-effective after a 5- to 10-year period, based on the HUI3, TTO, and VAS on hearing.CONCLUSION: This is the first study that describes a cost-utility analysis to compare unilateral with simultaneous bilateral CI in postlingually deafened adults, using a multicenter RCT. Compared with accepted societal willingness-to-pay thresholds, simultaneous bilateral CI is a cost-effective treatment for patients with a life expectancy of 5-10 years or longer.",

keywords = "Bilateral cochlear implantation, Cochlear implant, Cost-effectiveness, Cost-utility, Deafness, Hearing loss",

author = "Smulders, \{Yvette E\} and \{van Zon\}, Alice and Inge Stegeman and \{van Zanten\}, \{Gijsbert A\} and Rinia, \{Albert B\} and Stokroos, \{Robert J\} and Free, \{Rolien H\} and Bert Maat and Frijns, \{Johan H M\} and Mylanus, \{Emmanuel A M\} and Huinck, \{Wendy J\} and Vedat Topsakal and Wilko Grolman",

year = "2016",

month = jan,

doi = "10.1097/MAO.0000000000000901",

language = "English",

volume = "37",

pages = "38--45",

journal = "Otology \& Neurotology",

issn = "1531-7129",

publisher = "Lippincott Williams \& Wilkins",

number = "1",

}

Smulders, YE, van Zon, A, Stegeman, I, van Zanten, GA, Rinia, AB, Stokroos, RJ, Free, RH, Maat, B, Frijns, JHM, Mylanus, EAM, Huinck, WJ, Topsakal, V & Grolman, W 2016, 'Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial', Otology & Neurotology, vol. 37, no. 1, pp. 38-45. https://doi.org/10.1097/MAO.0000000000000901

TY - JOUR

T1 - Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults

T2 - A Randomized Controlled Trial

AU - Smulders, Yvette E

AU - van Zon, Alice

AU - Stegeman, Inge

AU - van Zanten, Gijsbert A

AU - Rinia, Albert B

AU - Stokroos, Robert J

AU - Free, Rolien H

AU - Maat, Bert

AU - Frijns, Johan H M

AU - Mylanus, Emmanuel A M

AU - Huinck, Wendy J

AU - Topsakal, Vedat

AU - Grolman, Wilko

PY - 2016/1

Y1 - 2016/1

N2 - OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI.STUDY DESIGN: Randomized controlled trial (RCT).SETTING: Five tertiary referral centers.PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.INTERVENTIONS: A cost-utility analysis was performed from a health insurance perspective.MAIN OUTCOME MEASURES: Utility was assessed using the HUI3, TTO, VAS on hearing, VAS on general health and EQ-5D. We modeled the incremental cost per quality-adjusted life year (QALY) of unilateral versus bilateral CI over periods of 2, 5, 10, 25 years, and actual life-expectancy.RESULTS: Direct costs for unilateral and bilateral CI were &OV0556;43,883 ± &OV0556;11,513(SD) and &OV0556;87,765 ± &OV0556;23,027(SD) respectively. Annual costs from the second year onward were &OV0556;3,435 ± &OV0556;1,085(SD) and &OV0556;6,871 ± &OV0556;2,169(SD), respectively. A cost-utility analysis revealed that a second implant became cost-effective after a 5- to 10-year period, based on the HUI3, TTO, and VAS on hearing.CONCLUSION: This is the first study that describes a cost-utility analysis to compare unilateral with simultaneous bilateral CI in postlingually deafened adults, using a multicenter RCT. Compared with accepted societal willingness-to-pay thresholds, simultaneous bilateral CI is a cost-effective treatment for patients with a life expectancy of 5-10 years or longer.

AB - OBJECTIVE: To study the cost-utility of simultaneous bilateral cochlear implantation (CI) versus unilateral CI.STUDY DESIGN: Randomized controlled trial (RCT).SETTING: Five tertiary referral centers.PATIENTS: Thirty-eight postlingually deafened adults eligible for cochlear implantation.INTERVENTIONS: A cost-utility analysis was performed from a health insurance perspective.MAIN OUTCOME MEASURES: Utility was assessed using the HUI3, TTO, VAS on hearing, VAS on general health and EQ-5D. We modeled the incremental cost per quality-adjusted life year (QALY) of unilateral versus bilateral CI over periods of 2, 5, 10, 25 years, and actual life-expectancy.RESULTS: Direct costs for unilateral and bilateral CI were &OV0556;43,883 ± &OV0556;11,513(SD) and &OV0556;87,765 ± &OV0556;23,027(SD) respectively. Annual costs from the second year onward were &OV0556;3,435 ± &OV0556;1,085(SD) and &OV0556;6,871 ± &OV0556;2,169(SD), respectively. A cost-utility analysis revealed that a second implant became cost-effective after a 5- to 10-year period, based on the HUI3, TTO, and VAS on hearing.CONCLUSION: This is the first study that describes a cost-utility analysis to compare unilateral with simultaneous bilateral CI in postlingually deafened adults, using a multicenter RCT. Compared with accepted societal willingness-to-pay thresholds, simultaneous bilateral CI is a cost-effective treatment for patients with a life expectancy of 5-10 years or longer.

KW - Bilateral cochlear implantation

KW - Cochlear implant

KW - Cost-effectiveness

KW - Cost-utility

KW - Deafness

KW - Hearing loss

UR - https://www.scopus.com/pages/publications/84952715177

U2 - 10.1097/MAO.0000000000000901

DO - 10.1097/MAO.0000000000000901

M3 - Article

C2 - 26649604

SN - 1531-7129

VL - 37

SP - 38

EP - 45

JO - Otology & Neurotology

JF - Otology & Neurotology

IS - 1

ER -

Cost-Utility of Bilateral Versus Unilateral Cochlear Implantation in Adults: A Randomized Controlled Trial

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Keywords

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