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Expensive today but cheaper tomorrow: lifetime costs of an active middle ear implant compared to alternative treatment options

Author

Listed:
  • Markus Krohn

    (University of Greifswald)

  • Klaas Kiesewetter

    (MED-EL Medical Electronics)

  • Annika Buchholz

    (Hannover Medical School)

  • Bettina Schlick

    (MED-EL Medical Electronics)

  • Susan Busch

    (Hannover Medical School)

  • Thomas Lenarz

    (Hannover Medical School)

  • Anke Lesinski-Schiedat

    (Hannover Medical School)

  • Hannes Maier

    (Hannover Medical School)

  • Cornelia Batsoulis

    (MED-EL Medical Electronics, MED-EL Research Center)

  • Michael Urban

    (MED-EL Medical Electronics)

  • Steffen Flessa

    (University of Greifswald)

Abstract

Background When choosing between different treatment options, implants often appear too costly. However, this perspective does not take future costs into account. This article evaluates lifetime costs for different surgical interventions to treat hearing loss. Methods The analysis focused on three groups from the perspective of health insurers. Group 1 comprises patients who have only been implanted with a middle ear implant. Patients in Group 2 had already undergone middle ear surgery to improve hearing prior to the implantation of a middle ear implant. Group 3 consists of patients who were treated exclusively with hearing-improvement surgeries (no implant). The lifetime costs were calculated using the Monte Carlo simulation. The inputs were based on medical data from a maximum-care hospital and data from the German healthcare system. Results Based on an average observation period of 26.73 years, the lifetime costs amounted to 28,325€ for group 1, 32,187€ for group 2 and 28,381€ for group 3. While the mean values between groups 1 and 3 appear comparable, group 1 has a significantly lower standard deviation (G1 vs. G3: 6120€ vs. 10,327€). Discussion/conclusion Choosing a treatment option can be a complex medical decision and impose a substantial economic burden for the statutory health insurance. Hence, treatment decisions should be patient-centred at first but also including a shared-decision making on economic feasibility, whether proposed treatment alternatives are likely to be successful and economically reasonable.

Suggested Citation

  • Markus Krohn & Klaas Kiesewetter & Annika Buchholz & Bettina Schlick & Susan Busch & Thomas Lenarz & Anke Lesinski-Schiedat & Hannes Maier & Cornelia Batsoulis & Michael Urban & Steffen Flessa, 2025. "Expensive today but cheaper tomorrow: lifetime costs of an active middle ear implant compared to alternative treatment options," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(5), pages 797-816, July.
  • Handle: RePEc:spr:eujhec:v:26:y:2025:i:5:d:10.1007_s10198-024-01743-6
    DOI: 10.1007/s10198-024-01743-6
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    Keywords

    Middle ear implant; Cost analysis; Lifetime cost; Monte-Carlo-Simulation; Hearing-improvement surgeries;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • C15 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Statistical Simulation Methods: General

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