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dc.contributor.authorCheng, Li-Jen
dc.contributor.authorSoon, Swee Sung
dc.contributor.authorWu, David Bin-Chia
dc.contributor.authorJu, Hong
dc.contributor.authorNg, Kwong
dc.date.accessioned2020-02-06T00:38:42Z
dc.date.available2020-02-06T00:38:42Z
dc.date.issued2019
dc.identifier.issn1932-6203
dc.identifier.doi10.1371/journal.pone.0220439
dc.identifier.urihttp://hdl.handle.net/10072/391120
dc.description.abstractA cochlear implant is a small electronic device that provides a sense of sound for the user, which can be used unilaterally or bilaterally. Although there is advocacy for the benefits of binaural hearing, the high cost of cochlear implant raises the question of whether its additional benefits over the use of an acoustic hearing aid in the contralateral ear outweigh its costs. This cost-effectiveness analysis aimed to separately assess the cost-effectiveness of simultaneous and sequential bilateral cochlear implantations compared to bimodal hearing (use of unilateral cochlear implant combined with an acoustic hearing aid in the contralateral ear) in children with severe-to-profound sensorineural hearing loss in both ears from the Singapore healthcare payer perspective. Incremental quality-adjusted life year (QALYs) gained and costs associated with bilateral cochlear implants over the lifetime horizon were estimated based on a four-state Markov model. The analysis results showed that, at the 2017 mean cost, compared to bimodal hearing, patients receiving bilateral cochlear implants experienced more QALYs but incurred higher costs, resulting in an incremental cost-effectiveness ratio (ICER) of USD$60,607 per QALY gained for simultaneous bilateral cochlear implantation, and USD$81,782 per QALY gained for sequential bilateral cochlear implantation. The cost-effectiveness of bilateral cochlear implants is most sensitive to utility gain associated with second cochlear implant, and cost of bilateral cochlear implants. ICERs increased when the utility gain from bilateral cochlear implants decreased; ICERs exceeded USD$120,000 per QALY gained when the utility gain was halved from 0.03 to 0.015 in both simultaneous and sequential bilateral cochlear implantations. The choice of incremental utility gain associated with the second cochlear implant is an area of considerable uncertainty.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherPublic Library of Science
dc.publisher.placeUnited States
dc.relation.ispartofissue8
dc.relation.ispartofjournalPLoS One
dc.relation.ispartofvolume14
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode1103
dc.titleCost-effectiveness analysis of bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears in Singapore
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationCheng, L-J; Soon, SS; Wu, DB-C; Ju, H; Ng, K, Cost-effectiveness analysis of bilateral cochlear implants for children with severe-to-profound sensorineural hearing loss in both ears in Singapore, PLoS One, 2019, 14 (8)
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2020-02-04T23:59:24Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2019 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
gro.hasfulltextFull Text
gro.griffith.authorJu, Hong


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