Cost-effectiveness Analysis Comparing Osia System to Percutaneous Bone Conduction Devices in Sweden

Area of Science:

• Audiology and Otolaryngology
• Health Economics
• Medical Devices

Background:

• Bone conduction devices (BCD) offer solutions for conductive hearing loss (CHL), mixed hearing loss (MHL), and single-sided deafness (SSD).
• BCDs significantly enhance hearing capacity, positively impacting patients' quality of life, mental health, education, and work.
• Devices are categorized as percutaneous or transcutaneous, with selection based on audiological outcomes, safety, patient preference, and cost.

Purpose of the Study:

• To evaluate the cost-effectiveness of the active transcutaneous Osia System compared to percutaneous bone conduction devices.
• To inform decision-making for healthcare providers and budgets regarding optimal BCD solutions for adult patients in Sweden.

Main Methods:

• A Markov model simulated adult patients (aged 59+) receiving either Osia or percutaneous BCDs over a lifetime horizon.
• Health states included device use, explantation/non-use, and death, with transition probabilities and utility scores (HUI3) derived from literature.
• Cost data from Swedish sources (Socialstyrelsen) were incorporated, with incremental cost-effectiveness ratio (ICER) per Quality-Adjusted Life Year (QALY) as the primary outcome.

Main Results:

• The Osia System demonstrated an incremental cost of 79,293 SEK and an increase of 0.73 QALYs compared to percutaneous devices.
• The resulting ICER was 108,318 SEK per QALY gained, indicating cost-effectiveness.
• Key drivers included baseline age, surgical costs, and differential utility scores, potentially linked to Osia's reduced complications and improved hearing.

Conclusions:

• The Osia System is considered cost-effective compared to percutaneous devices within Swedish willingness-to-pay thresholds.
• This economic analysis supports informed choices for selecting BCDs that align with patient needs and healthcare resource allocation.