scholarly journals Mini Review of the Cost-Effectiveness of Unilateral Osseointegrated Implants in Adults: Possibly Cost-Effective for the Correct Indication

2016 ◽  
Vol 21 (2) ◽  
pp. 69-71 ◽  
Author(s):  
Matthew G. Crowson ◽  
Debara L. Tucci
Keyword(s):  
Hearing Loss ◽  
Cost Effectiveness ◽  
Hearing Aid ◽  
Indirect Costs ◽  
Regulatory Body ◽  
Profound Hearing Loss ◽  
Aural Atresia ◽  
Osseointegrated Implants ◽  
Osseointegrated Implant ◽  
The Cost

An osseointegrated implant (e.g. bone-anchored hearing aid, BAHA) is a surgically implantable device for unilateral sensorineural and unilateral or bilateral conductive hearing loss in patients who otherwise cannot use or do not prefer a conventional air conduction hearing aid (ACHA). The specific indications for an osseointegrated implant are evolving and dependent upon the country or regulatory body overseeing the provision of these devices. However, there are general groups of patients who would be likely to benefit, one such group being patients with congenital aural atresia. Given the anatomical aberrancies with aural atresia, these subjects cannot wear ACHAs. Another group of patients who may benefit from an osseointegrated implant over an ACHA are patients with chronically draining otological infections. As the provision of an osseointegrated implant requires a surgical procedure, there are inherent direct and indirect costs associated with its use beyond those required for an ACHA. Consideration of outcomes and cost-effectiveness for the osseointegrated implant versus the ACHA is prudent prior to making policy decisions in a setting of limited health care resources. We performed a mini review on all available cost-effectiveness analyses of osseointegrated implants published in Medline. There are only 2 contemporary cost-effectiveness analyses published to date. There is limited quality of life data available for patients living with an osseointegrated implant. As a result, the cost-effectiveness of the osseointegrated implant, specifically the BAHA, compared to conventional hearing aid devices remains unclear. However, there are clear indications for the BAHA when a standard hearing aid cannot be used (e.g. chronic draining ear) or in single-sided severe-to-profound hearing loss with reasonable hearing in the contralateral ear. The BAHA should not be considered interchangeable with the ACHA with regard to cost-effectiveness, but rather considered as an effective option for the patient for the correct indication.

scholarly journals The cost-effectiveness of Cochlear implants in Swedish adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mutsa Gumbie ◽  
Emma Olin ◽  
Bonny Parkinson ◽  
Ross Bowman ◽  
Henry Cutler
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Cost Effectiveness ◽  
Cochlear Implants ◽  
Hearing Aid ◽  
Cost Effective ◽  
Profound Hearing Loss ◽  
Lifetime Horizon ◽  
The Cost

Abstract Background Research has shown unilateral cochlear implants (CIs) significantly improve clinical outcomes and quality of life in adults. However, only 13% of eligible Swedish adults currently use a unilateral CI. The objective was to estimate the cost-effectiveness of unilateral CIs compared to a hearing aid for Swedish adults with severe to profound hearing loss. Methods A Markov model with a lifetime horizon and six-month cycle length was developed to estimate the benefits and costs of unilateral CIs from the Swedish health system perspective. A treatment pathway was developed through consultation with clinical experts to estimate resource use and costs. Unit costs were derived from the Swedish National Board of Health and Welfare and the Swedish Association of Local Authorities and Regions. Health outcomes were reported in terms of Quality Adjusted Life Years (QALYs). Results Unilateral CIs for Swedish adults with severe to profound hearing loss are likely to be deemed cost-effective when compared to a hearing aid (SEK 140,474 per QALY gained). The results were most sensitive to the age when patients are implanted with a CI and the proportion of patients eligible for CIs after triage. Conclusions An increase in the prevalence of Swedish adults with severe to profound hearing loss is expected as the population ages. Earlier implantation of unilateral CIs improves the cost-effectiveness among people eligible for CIs. Unilateral CIs are an efficacious and cost-effective option to improve hearing and quality of life in Swedish adults with severe to profound hearing loss.

scholarly journals The cost-effectiveness of unilateral cochlear implants in UK adults

2021 ◽  
Author(s):  
Henry Cutler ◽  
Mutsa Gumbie ◽  
Emma Olin ◽  
Bonny Parkinson ◽  
Ross Bowman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Cost Effective ◽  
Profound Hearing Loss ◽  
Unit Costs ◽  
The Cost

Abstract Objective The National Institute for Health and Care Excellence (NICE) updated its eligibility criteria for unilateral cochlear implants (UCIs) in 2019. NICE claimed this would not impact the cost-effectiveness results used within its 2009 technology appraisal guidance. This claim is uncertain given changed clinical practice and increased healthcare unit costs. Our objective was to estimate the cost-effectiveness estimates of UCIs in UK adults with severe to profound hearing loss within the contemporary NHS environment. Methods A cost–utility analysis employing a Markov model was undertaken to compare UCIs with hearing aids or no hearing aids for people with severe to profound hearing loss. A clinical pathway was developed to estimate resource use. Health-related quality of life, potential adverse events, device upgrades and device failure were captured. Unit costs were derived mostly from the NHS data. Probabilistic sensitivity analysis further assessed the effect of uncertain model inputs. Results A UCI is likely to be deemed cost-effective when compared to a hearing aid (£11,946/QALY) or no hearing aid (£10,499/QALY). A UCI has an 93.0% and 98.7% likelihood of being cost-effective within the UK adult population when compared to a hearing aid or no hearing aid, respectively. ICERs were mostly sensitive to the proportion of people eligible for cochlear implant, discount rate, surgery and device costs and processor upgrade cost. Conclusion UCIs remain cost-effective despite changes to clinical practice and increased healthcare unit costs. Updating the NICE criteria to provide better access UCIs is projected to increase annual implants in adults and children by 70% and expenditure by £28.6 million within three years. This increased access to UCIs will further improve quality of life of recipients and overall social welfare.

scholarly journals The Use of Frequency Lowering Technology in the Treatment of Severe-to-Profound Hearing Loss: A Review of the Literature and Candidacy Considerations for Clinical Application

2018 ◽  
Vol 39 (04) ◽  
pp. 377-389 ◽  
Author(s):  
Susan Scollie ◽  
Danielle Glista
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Clinical Application ◽  
Current Literature ◽  
High Frequency ◽  
Hearing Aid ◽  
Verification And Validation ◽  
Review Of The Literature ◽  
Profound Hearing Loss

AbstractThis article provides a review of the current literature on the topic of frequency lowering hearing aid technology specific to the treatment of severe and profound levels of hearing impairment in child and adult listeners. Factors to consider when assessing listener candidacy for frequency lowering technology are discussed. These include factors related to audiometric assessment, the listener, the type of hearing aid technology, and the verification and validation procedures that can assist in determining candidacy for frequency lowering technology. An individualized candidacy assessment including the use of real-ear verification measures and carefully chosen validation tools are recommended for listeners requiring greater audibility of high-frequency sounds, when compared with amplification via conventional hearing aid technology.

scholarly journals Variations in cost calculations in spine surgery cost-effectiveness research

2014 ◽  
Vol 36 (6) ◽  
pp. E1 ◽  
Author(s):  
Matthew D. Alvin ◽  
Jacob A. Miller ◽  
Daniel Lubelski ◽  
Benjamin P. Rosenbaum ◽  
Kalil G. Abdullah ◽  
...  
Keyword(s):  
United Kingdom ◽  
Cost Effectiveness ◽  
Spine Surgery ◽  
Indirect Costs ◽  
Cost Calculation ◽  
Effectiveness Research ◽  
Reimbursement System ◽  
The United Kingdom ◽  
The Cost ◽  
Effectiveness Studies

Object Cost-effectiveness research in spine surgery has been a prominent focus over the last decade. However, there has yet to be a standardized method developed for calculation of costs in such studies. This lack of a standardized costing methodology may lead to conflicting conclusions on the cost-effectiveness of an intervention for a specific diagnosis. The primary objective of this study was to systematically review all cost-effectiveness studies published on spine surgery and compare and contrast various costing methodologies used. Methods The authors performed a systematic review of the cost-effectiveness literature related to spine surgery. All cost-effectiveness analyses pertaining to spine surgery were identified using the cost-effectiveness analysis registry database of the Tufts Medical Center Institute for Clinical Research and Health Policy, and the MEDLINE database. Each article was reviewed to determine the study subject, methodology, and results. Data were collected from each study, including costs, interventions, cost calculation method, perspective of cost calculation, and definitions of direct and indirect costs if available. Results Thirty-seven cost-effectiveness studies on spine surgery were included in the present study. Twenty-seven (73%) of the studies involved the lumbar spine and the remaining 10 (27%) involved the cervical spine. Of the 37 studies, 13 (35%) used Medicare reimbursements, 12 (32%) used a case-costing database, 3 (8%) used cost-to-charge ratios (CCRs), 2 (5%) used a combination of Medicare reimbursements and CCRs, 3 (8%) used the United Kingdom National Health Service reimbursement system, 2 (5%) used a Dutch reimbursement system, 1 (3%) used the United Kingdom Department of Health data, and 1 (3%) used the Tricare Military Reimbursement system. Nineteen (51%) studies completed their cost analysis from the societal perspective, 11 (30%) from the hospital perspective, and 7 (19%) from the payer perspective. Of those studies with a societal perspective, 14 (38%) reported actual indirect costs. Conclusions Changes in cost have a direct impact on the value equation for concluding whether an intervention is cost-effective. It is essential to develop a standardized, accurate means of calculating costs. Comparability and transparency are essential, such that studies can be compared properly and policy makers can be appropriately informed when making decisions for our health care system based on the results of these studies.

Cost Effectiveness of Whole Exome Sequencing for Children with Developmental Delay in a Developing Country: A Study from Jordan

2021 ◽  
Author(s):  
Amira Masri ◽  
Hanan Hamamy
Keyword(s):  
Cost Effectiveness ◽  
Exome Sequencing ◽  
Developmental Delay ◽  
Developing Country ◽  
Whole Exome Sequencing ◽  
Financial Burden ◽  
Indirect Costs ◽  
Cost Effective ◽  
Whole Exome ◽  
The Cost

AbstractThis retrospective study was aiming to determine the cost effectiveness of whole exome sequencing (WES) in the diagnosis of children with developmental delay in a developing country. In this study of 40 patients, the average cost of traditional investigations and indirect costs related to rehabilitation and medications per child were USD847 and 6,585 per year, respectively. With a current cost for WES of approximately USD1,200, we concluded that performing WES could be cost effective, even in countries with limited resources, as it provides the option for genetic counseling in affected families with an ultimate reduction of overall financial burden to both parents and health care system.

Knowledge and Expectations of Hearing Aid Applications: A Cross-sectional Survey of Smartphone Users and Hearing Professionals (Preprint)

2021 ◽  
Author(s):  
Jae Sang Han ◽  
Yong-Ho Park ◽  
Jae-Jun Song ◽  
Il Joon Moon ◽  
Woojoo Lee ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Personal Information ◽  
Hearing Aid ◽  
Assistive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cost Category ◽  
Grade Point ◽  
The Cost

BACKGROUND Despite the increasing prevalence of hearing loss, the cost and psychological barriers to use of hearing aids may prevent individuals with hearing loss from using these aids. Hearing loss patients can benefit from smartphone-based hearing aid applications (SHAAs), which are smartphone applications that use a mobile device as sound amplifier. OBJECTIVE The aims of this study were to determine how ear, nose and throat (ENT) outpatients perceived SHAAs, analyze factors that affected this, and estimate costs of annual subscription to an application through a self-administered questionnaire survey of smartphone users and hearing specialists. METHODS The study employed cross-sectional, multi-center survey of both ENT outpatients and hearing specialists. The questionnaire was designed to collect personal information about the respondents as well as responses to 18 questions concerning SHAAs in 5 domains: knowledge, needs, cost, expectations, and information. Questions about the expected cost of SHAAs were included in the questionnaire distributed to hearing experts. RESULTS Among 219 smartphone users and 42 hearing specialists, only eight respondents (3.7%) recognized SHAAs, while 47 of 261 respondents (21.5%) reported considering using an assistive device to improve their hearing capacities. Average perception score was 2.81 (95% CI 2.65-2.97), lower than the grade point average of 3. Among factors that shaped perceptions of SHAAs, the needs category received the lowest scores (2.02, 95% CI 1.83-2.20) whereas the cost category received the highest scores (3.29, 95% CI 3.14-3.44). Age was correlated with the information domain (P = .000) and an increased level of hearing impairment resulted in significantly higher points in the needs category (P = .000). Patients expected the cost of an annual application subscription to an SHAA to be about 86 USD, and predicted cost was associated with economic status (P = .200) and was noticeably higher than the prices expected by hearing specialists (P < .001). CONCLUSIONS Outpatients expected SHAAs to cost more than hearing specialists. However, SHAA perception was relatively low. In this regard, enhanced awareness of SHAAs is required to popularize SHAAs. CLINICALTRIAL None

scholarly journals Evidence of Acclimatization in Persons with Severe-to-Profound Hearing Loss

2003 ◽  
Vol 14 (02) ◽  
pp. 084-099 ◽  
Author(s):  
Francis K. Kuk ◽  
Lisa Potts ◽  
Michael Valente ◽  
Lidia Lee ◽  
Jay Picirrillo
Keyword(s):  
Hearing Loss ◽  
Speech Recognition ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Profound Hearing Loss ◽  
Secondary Purpose ◽  
Objective Performance ◽  
Recognition Testing ◽  
The One ◽  
Better Than

The present study examined the phenomenon of acclimatization in persons with a severe-to-profound hearing loss. A secondary purpose was to examine the efficacy of a digital nonlinear power hearing aid that has a low compression threshold with expansion for this population. Twenty experienced hearing aid users wore the study hearing aids for three months and their performance with the study hearing aids was evaluated at the initial fitting, one month, and three months after the initial fitting. Performance of their current hearing aids was also evaluated at the initial fitting. Speech recognition testing was conducted at input levels of 50 dB SPL and 65 dB SPL in quiet, and 75 dB SPL in noise at a +10 SNR. Questionnaires were used to measure subjective performance at each evaluation interval. The results showed improvement in speech recognition score at the one-month evaluation over the initial evaluation. No significant improvement was seen at the three-month evaluation from the one-month visit. In addition, subjective and objective performance of the study hearing aids was significantly better than the participants' own hearing aids at all evaluation intervals. These results provided evidence of acclimatization in persons with a severe-to-profound hearing loss and reinforced the precaution that any trial of amplification, especially from linear to nonlinear mode, should consider this phenomenon.

The Hearing Performance Inventory and Hearing Aid Use in Profound Hearing Loss

1980 ◽  
Vol 23 (2) ◽  
pp. 470-479 ◽  
Author(s):  
Elmer Owens ◽  
Sharon Fujikawa
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Superior Performance ◽  
Profound Hearing Loss ◽  
Hearing Aid Use

Subjects with profound postlingual hearing loss completed the Hearing Performance Inventory (HPI) during the course of their hearing aid evaluations. Comparisons of responses to the HPI were made for (a) subjects who wore hearing aids versus subjects who did not, and (b)hearing aid users with losses greater than 100 dB versus users with losses between 80-100 dB. The former set of comparisons indicated consistently superior performance for the aided group, and the latter set indicated consistently superior performance for the 80-100 dB group. The HPI may be a valuable tool in hearing aid considerations.

scholarly journals The Cost-effectiveness of Hearing-Aid Fitting in the Netherlands

2003 ◽  
Vol 129 (3) ◽  
pp. 297 ◽  
Author(s):  
Manuela A. Joore ◽  
Hans van der Stel ◽  
Hans J. M. Peters ◽  
Gijs M. Boas ◽  
Lucien J. C. Anteunis
Keyword(s):  
Cost Effectiveness ◽  
The Netherlands ◽  
Hearing Aid ◽  
Hearing Aid Fitting ◽  
Fitting In ◽  
The Cost

Effects of Universal Newborn Hearing Screening on an Early Intervention Program for Children with Hearing Loss, Birth to 3 Yr of Age

2010 ◽  
Vol 21 (03) ◽  
pp. 169-175 ◽  
Author(s):  
Kathy S. Halpin ◽  
Kay Y. Smith ◽  
Judith E. Widen ◽  
Mark E. Chertoff
Keyword(s):  
Hearing Loss ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Late Onset ◽  
Hearing Aid ◽  
Profound Hearing Loss ◽  
Universal Newborn Hearing Screening ◽  
Before And After ◽  
Age Of Diagnosis ◽  
Diagnosis Age

Background: Universal Newborn Hearing Screening (UNHS) was introduced in Kansas in 1999. Prior to UNHS a small percentage of newborns were screened for and identified with hearing loss. Purpose: The purpose of this study was to determine the effects of UNHS on a local early intervention (EI) program for young children with hearing loss. Research Design: This was a retrospective study based on the chart review of children enrolled in the EI program during target years before and after the establishment of UNHS. Study Sample: Charts for 145 children were reviewed. Data Collection and Analysis: The chart review targeted the following aspects of the EI program: caseload size, percentage of caseload identified by UNHS, age of diagnosis, age of enrollment in EI, degree of hearing loss, etiology of hearing loss, late onset of hearing loss, age of hearing aid fit, percentage of children fit with hearing aids by 6 mo, percentage of children with profound hearing loss with cochlear implants, and percentage of children with additional disabilities. Results: Changes in the EI program that occurred after UNHS were increases in caseload size, percentage of caseload identified by UNHS, percentage of children fit with hearing aids by 6 mo of age, and percentage of children with profound hearing loss with cochlear implants. There were decreases in age of diagnosis, age of enrollment in EI, and age of hearing aid fit. Before UNHS, the majority of children had severe and profound hearing loss; after UNHS there were more children with mild and moderate hearing loss. The percentage of known etiology and late-onset hearing loss was approximately the same before and after UNHS, as was the percentage of children with additional disabilities. Conclusion: UNHS had a positive impact on caseload size, age of diagnosis, age of enrollment in EI, and age of hearing aid fit. The percentage of the caseload identified in the newborn period was about 25% before UNHS and over 80% after its implementation. After UNHS, the EI caseload included as many children with mild and moderate hearing loss as with severe and profound loss. By the last reporting year in the study (academic year 2005–2006) all children with profound hearing losses had cochlear implants.

Sign in / Sign up

Export Citation Format

Share Document