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Cost-Effectiveness of Neonatal Hearing Screening Programs: A Micro-Simulation Modeling Analysis.

Mirjam L Verkleij1, Eveline A M Heijnsdijk1, Andrea M L Bussé2,3

  • 1Department of Public Health, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.

Ear and Hearing
|December 11, 2020
PubMed
Summary
This summary is machine-generated.

Implementing a two-stage otoacoustic emissions (OAE) followed by automated auditory brainstem response (aABR) neonatal hearing screening is cost-effective for Albania. This protocol balances early detection of hearing impairment with financial feasibility.

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Area of Science:

  • Public Health
  • Health Economics
  • Audiology

Background:

  • Early detection of neonatal hearing impairment is crucial for speech and language development.
  • Universal neonatal hearing screening protocols vary significantly in implementation.
  • Albania sought to determine the most cost-effective screening approach.

Purpose of the Study:

  • To estimate the cost-effectiveness of various neonatal hearing screening protocols for Albania.
  • To inform the implementation of a national neonatal hearing screening program.

Main Methods:

  • A micro-simulation model was developed incorporating demographic data, disease natural history, and screening/treatment characteristics.
  • Multiple protocols using otoacoustic emissions (OAE) and automated auditory brainstem response (aABR) were simulated.
  • Cost-effectiveness was analyzed over a lifetime horizon.

Main Results:

  • The two-stage OAE-aABR protocol in maternity wards and single-stage aABR were identified as the best protocols.
  • The two-stage OAE-aABR protocol had an incremental cost-effectiveness ratio of €4181 per quality-adjusted life-year gained.
  • Single-stage aABR detected more cases but incurred higher diagnostic costs due to increased referrals.

Conclusions:

  • Only the two-stage OAE-aABR protocol fell below Albania's willingness-to-pay threshold (€10,413) and was deemed cost-effective.
  • This study provides a comprehensive lifetime cost-effectiveness analysis of multiple neonatal hearing screening scenarios.