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Simultaneous versus sequential bilateral cochlear implants in adults: Cost analysis in a US setting.

Aaron Trinidade1, Joshua C Page1, Sarah W Kennett2,3

  • 1Otolaryngology Department, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.

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|June 6, 2017
PubMed
Summary

Simultaneous cochlear implantation (SimCI) may be more cost-effective than sequential cochlear implantation (SeqCI) in adults. This analysis shows SeqCI can incur higher overall patient management costs, especially when audiological costs are considered.

Keywords:
Cochlear implantcost analysissequential implantationsimultaneous implantation

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Area of Science:

  • Otolaryngology
  • Health Economics

Background:

  • Simultaneous cochlear implantation (SimCI) is generally considered more cost-effective than sequential cochlear implantation (SeqCI).
  • However, the cost-effectiveness of SimCI versus SeqCI may vary in settings where only SeqCI is practiced and not all unilaterally implanted patients proceed to a second implant.

Purpose of the Study:

  • To conduct a cost analysis comparing SimCI and SeqCI in an institutional setting where SeqCI is the standard practice.
  • To evaluate the financial implications of patients not progressing to a second cochlear implant after initial unilateral implantation.

Main Methods:

  • Retrospective review of patient data from 2005 to 2015.
  • Cost analysis including hospital, surgical, implant, and audiological costs for 29 adult patients.

Main Results:

  • The total cost for 29 patients undergoing SeqCI (with 27.3% progressing to a second implant) was $3,482,171.46.
  • SimCI for all 29 patients would have cost $3,332,991.75, representing a potential saving of $149,179.67 (4.3%).

Conclusions:

  • In institutions practicing only SeqCI for adults, overall patient management costs may be marginally higher than with SimCI.
  • Findings are relevant for cochlear implant programs and health insurance providers.