Cost-utility of cochlear implantation in single-sided deafness and asymmetric hearing loss: results of a randomized controlled trial
Year: 2024
Type: article
Study design: Clinical Trial
Abstract: OBJECTIVES: To determine the Incremental Cost-Utility Ratio (ICUR) of cochlear implantation in the treatment of adult patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL). METHODS: This prospective multicenter pragmatic study including a randomized controlled trial (RCT) enrolled 155 subjects with SSD or AHL. Subjects chose a treatment option between: abstention, Contralateral Routing Of the Signal hearing aids, Bone Conduction Device or Cochlear Implant (CI). Participants who opted for CI were then randomized between two arms: "immediate CI" where the cochlear implantation was performed within one month and "initial observation" where subjects were first observed. The ICUR of CI was determined at 6 months follow-up by comparing the two arms. Utility was measured using EuroQoL- 5 dimensions (EQ-5D), to calculate the gain in Quality-Adjusted Life Years (QALY). Individual costs were extracted from the French National Health Insurance database. A Markovian MultiState (MMS) model assessed the ICUR evolution over the lifetime horizon. RESULTS: Among the 155 included participants, 51 opted for a CI and were randomized. For a 6 months follow-up period, the ICUR was €422,279/QALY gained after CI. Using the MMS model, the ICUR of CI decreased to €57,561/QALY at 10 years follow-up, €38,006/QALY at 20 years, and dropped to €26,715 at 50 years. In the participants with severe tinnitus, mean ICUR was €31,105/QALY at 10 years. CONCLUSIONS: CI can be considered as an efficient treatment in SSD and AHL from 20 years follow-up in the global population, and before 10 years follow-up in patients with severe associated tinnitus.
Authors: Mathieu Marx, Michaël Mounié, Isabelle Mosnier, Frédéric Venail, Michel Mondain, Alain Uziel, David Bakhos, Emmanuel Lescanne, Yann N’Guyen, Daniele Bernardeschi, Olivier Sterkers, Benoit Godey, Gwenaëlle Creff, Sébastien Schmerber, Nicolas-Xavier Bonne, Christophe Vincent, Bernard Fraysse, Olivier Deguine, Nadège Costa
Institutions: Université Toulouse III - Paul Sabatier, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Centre de recherche cerveau et cognition, Inserm, Institut Pasteur, Université Paris Cité, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institut de l'Audition, Hôpital Gui de Chauliac, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Centre Hospitalier Universitaire de Grenoble, Université de Lille, Centre Hospitalier Universitaire de Lille, Protéomique, Réponse Inflammatoire et Spectrométrie de Masse, Hôpital Roger Salengro
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
OpenAlex ID: W4404511952