Cost-effectiveness analysis of the bone-anchored hearing device.

OBJECTIVE To establish the cost-effectiveness of a bone-anchored hearing device (BAHD). To date, there has not been any formal economic analysis of this treatment. STUDY DESIGN A prospective cohort case-control analysis. SETTING Tertiary referral center, university hospital. PATIENTS Between April 2007 and June 2008, all adult patients undergoing their first BAHD were contacted and invited to take part in this study. Data of 70 patients were completed during the study period and were analyzed. INTERVENTIONS A health utility measure was made before and after the insertion of a BAHD to estimate the utility gain associated with this intervention. MAIN OUTCOME MEASURES The cost and quality-adjusted life year (QALY) gain for each patient was established, and an incremental cost-effectiveness ratio (ICER) was calculated. RESULTS The results of our analysis are that, compared with current standard care, the BAHD has an ICER of £17,610 (US $26,415) per QALY gained. The National Institute for Health and Clinical Excellence will endorse a health intervention as cost-effective if the ICER is below £20,000 to £30,000 per QALY (US $30,000-45,000). CONCLUSION This technology is likely to be cost-effective at the current thresholds used by National Institute for Health and Clinical Excellence. Therefore, this study suggests the BAHD may be a cost-effective method of auditory rehabilitation.