Cost-utility of cochlear implantation in single-sided deafness and asymmetric hearing loss: results of a randomized controlled trial

Mathieu Marx (), Michaël Mounié, Isabelle Mosnier, Frédéric Venail, Michel Mondain, Alain Uziel, David Bakhos, Emmanuel Lescanne, Yann N’Guyen, Daniele Bernardeschi, Olivier Sterkers, Benoit Godey, Gwenaëlle Creff, Sébastien Schmerber, Nicolas-Xavier Bonne, Christophe Vincent, Bernard Fraysse, Olivier Deguine and Nadège Costa
Additional contact information
Mathieu Marx: Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan
Michaël Mounié: Unité d’Evaluation Médico-Economique, CHU Toulouse
Isabelle Mosnier: AP-HP Sorbonne Université
Frédéric Venail: Hôpital Gui de Chauliac, CHU Montpellier
Michel Mondain: Hôpital Gui de Chauliac, CHU Montpellier
Alain Uziel: Hôpital Gui de Chauliac, CHU Montpellier
David Bakhos: Hôpital Bretonneau, CHU Tours
Emmanuel Lescanne: Hôpital Bretonneau, CHU Tours
Yann N’Guyen: AP-HP Sorbonne Université
Daniele Bernardeschi: AP-HP Sorbonne Université
Olivier Sterkers: AP-HP Sorbonne Université
Benoit Godey: Hôpital Pontchaillou, CHU Rennes
Gwenaëlle Creff: Hôpital Pontchaillou, CHU Rennes
Sébastien Schmerber: CHU Grenoble
Nicolas-Xavier Bonne: Service d’ORL, U1192 – PRISM
Christophe Vincent: Hôpital Salengro, CHU Lille
Bernard Fraysse: Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan
Olivier Deguine: Hôpital Pierre-Paul Riquet, CHU Toulouse Purpan
Nadège Costa: Unité d’Evaluation Médico-Economique, CHU Toulouse

The European Journal of Health Economics, 2025, vol. 26, issue 5, No 4, 735-744

Abstract: Abstract Objectives To determine the Incremental Cost-Utility Ratio (ICUR) of cochlear implantation in the treatment of adult patients with single-sided deafness (SSD) and asymmetric hearing loss (AHL). Methods This prospective multicenter pragmatic study including a randomized controlled trial (RCT) enrolled 155 subjects with SSD or AHL. Subjects chose a treatment option between: abstention, Contralateral Routing Of the Signal hearing aids, Bone Conduction Device or Cochlear Implant (CI). Participants who opted for CI were then randomized between two arms: “immediate CI” where the cochlear implantation was performed within one month and “initial observation” where subjects were first observed. The ICUR of CI was determined at 6 months follow-up by comparing the two arms. Utility was measured using EuroQoL- 5 dimensions (EQ-5D), to calculate the gain in Quality-Adjusted Life Years (QALY). Individual costs were extracted from the French National Health Insurance database. A Markovian MultiState (MMS) model assessed the ICUR evolution over the lifetime horizon. Results Among the 155 included participants, 51 opted for a CI and were randomized. For a 6 months follow-up period, the ICUR was €422,279/QALY gained after CI. Using the MMS model, the ICUR of CI decreased to €57,561/QALY at 10 years follow-up, €38,006/QALY at 20 years, and dropped to €26,715 at 50 years. In the participants with severe tinnitus, mean ICUR was €31,105/QALY at 10 years. Conclusions CI can be considered as an efficient treatment in SSD and AHL from 20 years follow-up in the global population, and before 10 years follow-up in patients with severe associated tinnitus.

Keywords: Single-sided deafness; Asymmetric hearing loss; ICUR; Cochlear implant; Tinnitus (search for similar items in EconPapers)
JEL-codes: I18 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01740-9

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