Evaluating the Cost-Effectiveness of Unilateral Cochlear Implants Versus Hearing Aids in Older Adults in Japan.

IF 1.9 3区 医学 Q3 CLINICAL NEUROLOGY
Norie Imagawa, Shuji Izumi, Takashi Shimazaki, Takashi Yamauchi, Shunya Ikeda, Shinichi Noto, Hiromi Kojima, Machi Suka
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Abstract

Objectives: This study aimed to evaluate the cost-effectiveness of cochlear implants in older adults with hearing impairment 65 years or older in Japan. In addition, this study aimed to establish a basis for making recommendations for cochlear implants in clinical practice for suitable patients.

Design: We conducted a cost-utility analysis using the incremental cost-effectiveness ratio (ICER) to compare unilateral cochlear implants with hearing aids. The study involved participants 65 years or older with severe-to-profound hearing loss attending two cochlear implant surgery facilities in Japan. Costs were calculated from the participants' receipt data and standard clinical paths from medical care providers. Quality-adjusted life years (QALY) were assessed by patients using the Japanese version of the Health Utilities Index Mark 3 and by medical care providers using the visual analog scale (VAS). In addition, sensitivity analyses were performed by varying the utility value, discount rate, age at implantation, and costs to estimate the ICER under different scenarios.

Results: Responses were received from 26 cochlear implant users and 8 hearing aid users. After applying the survival and discount rates to the utility values and costs, the ICER was $44,533, which falls within the acceptable willingness-to-pay threshold in Japan. Sensitivity analysis showed that the ICER was the most sensitive to the utility value, followed by the discount rate.

Conclusions: The findings indicate that providing cochlear implants to older adults with hearing impairment is not only beneficial in terms of improved hearing performance but also economically efficient.

评估日本老年人单侧人工耳蜗与助听器的成本效益。
目的:本研究旨在评估日本65岁以上听力障碍老年人人工耳蜗植入的成本效益。此外,本研究旨在为在临床实践中为合适的患者推荐人工耳蜗奠定基础。设计:我们使用增量成本-效果比(ICER)进行成本-效用分析,比较单侧人工耳蜗与助听器。这项研究的参与者年龄在65岁以上,患有严重到深度的听力损失,他们在日本的两家人工耳蜗手术机构接受手术。费用是根据参与者的收据数据和医疗保健提供者的标准临床路径计算的。质量调整生命年(QALY)由患者使用日本版健康效用指数标记3进行评估,由医疗保健提供者使用视觉模拟量表(VAS)进行评估。此外,通过改变效用值、贴现率、植入年龄和成本进行敏感性分析,以估计不同情况下的ICER。结果:收到26名人工耳蜗使用者和8名助听器使用者的反馈。在将生存率和贴现率应用于效用价值和成本之后,ICER为44,533美元,处于日本可接受的支付意愿阈值之内。敏感性分析表明,ICER对效用值最敏感,其次是贴现率。结论:研究结果表明,为老年听力障碍患者提供人工耳蜗不仅有利于改善听力表现,而且经济有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Otology & Neurotology
Otology & Neurotology 医学-耳鼻喉科学
CiteScore
3.80
自引率
14.30%
发文量
509
审稿时长
3-6 weeks
期刊介绍: ​​​​​Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.
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