Expensive today but cheaper tomorrow: lifetime costs of an active middle ear implant compared to alternative treatment options

Markus Krohn (), Klaas Kiesewetter, Annika Buchholz, Bettina Schlick, Susan Busch, Thomas Lenarz, Anke Lesinski-Schiedat, Hannes Maier, Cornelia Batsoulis, Michael Urban and Steffen Flessa
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Markus Krohn: University of Greifswald
Klaas Kiesewetter: MED-EL Medical Electronics
Annika Buchholz: Hannover Medical School
Bettina Schlick: MED-EL Medical Electronics
Susan Busch: Hannover Medical School
Thomas Lenarz: Hannover Medical School
Anke Lesinski-Schiedat: Hannover Medical School
Hannes Maier: Hannover Medical School
Cornelia Batsoulis: MED-EL Medical Electronics, MED-EL Research Center
Michael Urban: MED-EL Medical Electronics
Steffen Flessa: University of Greifswald

The European Journal of Health Economics, 2025, vol. 26, issue 5, No 8, 797-816

Abstract: Abstract Background When choosing between different treatment options, implants often appear too costly. However, this perspective does not take future costs into account. This article evaluates lifetime costs for different surgical interventions to treat hearing loss. Methods The analysis focused on three groups from the perspective of health insurers. Group 1 comprises patients who have only been implanted with a middle ear implant. Patients in Group 2 had already undergone middle ear surgery to improve hearing prior to the implantation of a middle ear implant. Group 3 consists of patients who were treated exclusively with hearing-improvement surgeries (no implant). The lifetime costs were calculated using the Monte Carlo simulation. The inputs were based on medical data from a maximum-care hospital and data from the German healthcare system. Results Based on an average observation period of 26.73 years, the lifetime costs amounted to 28,325€ for group 1, 32,187€ for group 2 and 28,381€ for group 3. While the mean values between groups 1 and 3 appear comparable, group 1 has a significantly lower standard deviation (G1 vs. G3: 6120€ vs. 10,327€). Discussion/conclusion Choosing a treatment option can be a complex medical decision and impose a substantial economic burden for the statutory health insurance. Hence, treatment decisions should be patient-centred at first but also including a shared-decision making on economic feasibility, whether proposed treatment alternatives are likely to be successful and economically reasonable.

Keywords: Middle ear implant; Cost analysis; Lifetime cost; Monte-Carlo-Simulation; Hearing-improvement surgeries (search for similar items in EconPapers)
JEL-codes: C15 I10 I11 I13 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01743-6

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