An economic evaluation of the healthcare cost of tinnitus management in the UK

Abstract

BackgroundThere is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness.MethodsCurrent treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained.ResultsThe average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies.ConclusionsNHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2527-2) contains supplementary material, which is available to authorized users.

A Framework for Designing and Evaluating Internet Interventions to Improve Tinnitus Care

“…Provision of healthcare cannot be considered without evidence of the cost-effectiveness of these interventions. As no cure has been identified, treating tinnitus remains challenging and costly at an estimated annual healthcare cost of £750 million and resulting societal cost of £2.7 billion per year in the UK (Stockdale et al, 2017). Due to its chronic nature, healthcare services are further pressurised as processes are often extensive and often encompass referrals to various disciplines to address hearing difficulties and possible indirect psychosocial effects (Cima et al, 2009).…”

Hidden hearing loss and tinnitus: Utility of the high‐definition audiograms in diagnosis

“…Tinnitus, defined as a phantom sensation of sound, is experienced by between 10% and 15% of the adult population. A recent study in the UK determined that the average cost of tinnitus treatment is about GB£750 million per year . The Royal National Institute for Deaf People (RNID) referred to hearing loss and tinnitus as ‘the hidden healthcare time bomb’ …”

“…A recent study in the UK determined that the average cost of tinnitus treatment is about GB£750 million per year. 1 The Royal National Institute for Deaf People (RNID) referred to hearing loss and tinnitus as 'the hidden healthcare time bomb'. 2 Patients with hearing loss and tinnitus can benefit from hearing aids depending on the precise determination of the hearing loss and tinnitus characteristics.…”

Internet-based interventions for adults with hearing loss, tinnitus and vestibular disorders: a protocol for a systematic review

“…Unaddressed hearing loss poses an annual global cost of $750 billion dollars [25]. The annual cost of tinnitus interventions in the UK was calculated to be £750 million in total and the annual societal costs relating to tinnitus was calculated at £2.7 billion [26]. In the USA, the annual economic burdens of unilateral and bilateral vestibular disorders were found to be $3531–$13,019 per patient [27].…”