Cost-Effectiveness of Unilateral Cochlear Implants in Chinese Adults: Decision Analytical Modeling.

OBJECTIVE

This study aimed to evaluate the cost-effectiveness of unilateral cochlear implants (UCIs) in Chinese adults with severe or profound sensorineural hearing loss, which helps to inform the introduction of a new intervention for underserved adult patients with severe hearing loss.

STUDY

DESIGN

Cost-effectiveness analysis.

SETTING

Six tertiary hospitals located in north, east, south, and west China, designated as National Regional Medical Centers or WHO Collaborating Centers for the Prevention of Deafness.

METHODS

Using a Markov model, we conducted cost effectiveness analysis over the patient's lifetime and from the perspective of the Chinese healthcare system. Costs and outcomes are discounted by 5% annually. Compared with the control measures of hearing aids (HAs), interventions for UCIs include surgery, rehabilitation, regular maintenance, and periodic replacements.

RESULTS

The incremental cost of UCIs versus HAs was 216,414.37 CNY, which was accompanied by an incremental utility value of 3.34 QALYs. Therefore, UCIs demonstrated superior cost-effectiveness compared with HAs. The incremental cost-effectiveness ratio (ICER) was 64,794.72 Chinese yuan (CNY)/quality-adjusted life years (QALY), indicating that the cost required to gain one additional QALY was 64,794.72 CNY. The ICER was below the World Health Organization-recommended threshold of 1 to 3 times the GDP per capita (China's 2022 GDP per capita range = 85,698-257,094 CNY) and falls within 47% to 88% of the per capita GDP (research estimates 77%). Sensitivity analyses and age-based scenario analyses indicated good stability of the results.

CONCLUSIONS

UCIs are a cost-effective intervention for adults in China.