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Cost-utility of cochlear implantation in single-sided deafness and asymmetric hearing loss: results of a randomized controlled trial

Author

Listed:
  • Mathieu Marx

    (Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan
    Brain & Cognition Research Centre, UMR 5549, Université Toulouse III)

  • Michaël Mounié

    (Unité d’Evaluation Médico-Economique, CHU Toulouse)

  • Isabelle Mosnier

    (AP-HP Sorbonne Université
    Institut Pasteur / Inserm/ Université Paris Cité)

  • Frédéric Venail

    (Hôpital Gui de Chauliac, CHU Montpellier)

  • Michel Mondain

    (Hôpital Gui de Chauliac, CHU Montpellier)

  • Alain Uziel

    (Hôpital Gui de Chauliac, CHU Montpellier)

  • David Bakhos

    (Hôpital Bretonneau, CHU Tours)

  • Emmanuel Lescanne

    (Hôpital Bretonneau, CHU Tours)

  • Yann N’Guyen

    (AP-HP Sorbonne Université
    Institut Pasteur / Inserm/ Université Paris Cité)

  • Daniele Bernardeschi

    (AP-HP Sorbonne Université
    Institut Pasteur / Inserm/ Université Paris Cité)

  • Olivier Sterkers

    (AP-HP Sorbonne Université
    Institut Pasteur / Inserm/ Université Paris Cité)

  • Benoit Godey

    (Hôpital Pontchaillou, CHU Rennes)

  • Gwenaëlle Creff

    (Hôpital Pontchaillou, CHU Rennes)

  • Sébastien Schmerber

    (CHU Grenoble)

  • Nicolas-Xavier Bonne

    (Service d’ORL, U1192 – PRISM)

  • Christophe Vincent

    (Hôpital Salengro, CHU Lille)

  • Bernard Fraysse

    (Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan)

  • Olivier Deguine

    (Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan
    Brain & Cognition Research Centre, UMR 5549, Université Toulouse III)

  • Nadège Costa

    (Unité d’Evaluation Médico-Economique, CHU Toulouse)

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.

Suggested Citation

  • Mathieu Marx & Michaël Mounié & Isabelle Mosnier & Frédéric Venail & Michel Mondain & Alain Uziel & David Bakhos & Emmanuel Lescanne & Yann N’Guyen & Daniele Bernardeschi & Olivier Sterkers & Benoit G, 2025. "Cost-utility of cochlear implantation in single-sided deafness and asymmetric hearing loss: results of a randomized controlled trial," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(5), pages 735-744, July.
  • Handle: RePEc:spr:eujhec:v:26:y:2025:i:5:d:10.1007_s10198-024-01740-9
    DOI: 10.1007/s10198-024-01740-9
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    More about this item

    Keywords

    Single-sided deafness; Asymmetric hearing loss; ICUR; Cochlear implant; Tinnitus;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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