Time-Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program

Area of Science:

• Health Economics
• Otolaryngology
• Medical Technology Assessment

Background:

• Cochlear implant (CI) programs are essential for individuals with severe to profound hearing loss.
• Accurate cost assessment is vital for sustainable healthcare program management.
• Previous cost analyses for CI programs are limited, particularly from a Canadian provincial perspective.

Purpose of the Study:

• To determine the comprehensive annual cost of operating an adult cochlear implant program.
• To analyze costs associated with patient assessment, implantation, and follow-up.
• To provide a Canadian provincial government perspective on CI program expenditures.

Main Methods:

• Utilized Time-Driven Activity-Based Costing (TDABC) to model the CI program.
• Developed and validated clinical scenario pathways with stakeholders.
• Calculated costs based on all patients referred in 2019, with figures updated to 2023 Canadian dollars.

Main Results:

• The total annual cost for the CI program in 2019 was $4.542 million CAD ($3.365 million USD).
• The cost per implanted patient was $29,511 CAD ($21,865 USD).
• The cochlear implant device represented the highest single cost, followed by surgical and switch-on day expenses, and audiological assessments; labor costs were significant across other steps.

Conclusions:

• The TDABC model provides a detailed cost breakdown for adult CI programs.
• The total annual cost for managing all referrals was substantial, highlighting the financial commitment required.
• The high cost of the CI device itself is a primary driver of overall program expenditure.