Journal Article

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

Lescanne, Emmanuel, Sterkers, Olivier, Costa, Nadège, Venail, Frédéric, Schmerber, Sébastien, Creff, Gwenaëlle, Mondain, Michel, N’Guyen, Yann, Mounié, Michaël, Deguine, Olivier, Bakhos, David, Godey, Benoit, Vincent, Christophe, Mosnier, Isabelle, Fraysse, Bernard, Uziel, Alain, Bonne, Nicolas-Xavier, Marx, Mathieu, Bernardeschi, Daniele

2025

Overview

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.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V,Springer Verlag
• Subject: Adult / Adults / Aged / Clinical outcomes / Clinical trials / Cochlear Implantation / Cochlear Implantation - economics / Cochlear Implants / Cochlear Implants - economics / Cost analysis / Cost-Benefit Analysis / Deafness / Deafness - surgery / Ecology, environment / Economic Policy / Female / France / Health / Health Care Management / Health Economics / Hearing Aids / Hearing Aids - economics / Hearing loss / Hearing Loss, Unilateral / Hearing Loss, Unilateral - economics / Hearing Loss, Unilateral - surgery / Humans / Life Sciences / Localization / Male / Medical equipment / Medicine / Medicine & Public Health / Middle Aged / Original Paper / Pharmacoeconomics and Health Outcomes / Prospective Studies / Public Finance / Public Health / Quality of life / Quality-Adjusted Life Years / Tinnitus / Transplants & implants / Voice recognition