The economics of cochlear implant management in France: a multicentre analysis

Abstract

This study assessed the direct medical cost of cochlear implantation in children and adults in France. A prospective multicentre study involving 19 French University Hospitals included 268 children and 201 adults who were severely to profoundly hearing-impaired. Medical resources utilisation included diagnostic tests, in-patient care, device implants, adverse events and follow-up visits for rehabilitation in the 1st year. The mean costs were <euro>34,686 per child and <euro>31,946 per adult. The cost of device implant represents 64.4% and 68.8% of the total cost for children and adults, respectively. The current reform of financing of the healthcare system requires detailed knowledge of the costs of interventions, hence the costs of cochlear implantation should be factored into resource allocation decisions. Differences in our results compared to other studies can be explained mostly by methodological differences in cost analyses.

Costs involved in using a cochlear implant in South Africa

“…The cochlear implant system was the greatest single cost involved in the implantation process. This result was similar to the findings in a recent French study, which also reported the cost of the device as the main cost in implantation (Molinier, Bocquet, Bongard & Frayesse, 2009). In that study the cost of the device represented 64.4% and 68.8% of the total cost for children and adults respectively.…”

The Cost of Cochlear Implantation: A Review of Methodological Considerations

“…Sixteen studies were carried out in Europe [2–7, 9, 10, 12–14, 24–27], 7 in North America [7, 15–17, 19, 20, 22], 2 in Asia [28, 29], and 1 in Australia [23]. …”

“…Eight studies were cost analysis studies [2–4, 9, 19, 24, 25, 27], and 18 were global economic evaluations, including 16 cost-utility analyses [5–8, 10, 12–16, 20–23, 28, 29] and 2 costs-benefit analysis [17, 26]. …”

“…Five methodologists (N. Costa, H. Derumeaux-Burel, L. Ferlicoq, V. Garnault, and L. Molinier) each read the 37 papers retrieved by the search strategy and reviewed the 26 selected papers. L. Molinier did not participated in the analysis to the study he previously published “The economics of cochlear implant management in France: a multicentre analysis” [24]. In keeping with the key methodological points identified in the first part of the paper, they asked questions based on existing checklists for full economic evaluations [32, 45].…”

“…In the face of scarce resources, decision makers are not only interested in the effectiveness of certain healthcare interventions but also in the costs that are involved. Several studies have analysed the costs of cochlear implants, in particular in the United Kingdom [2–14], United States [15–22], Australia [23], France [24], The Netherlands [25], Germany [26], Belgium [27], and Asia [28, 29], and some of these studies have shown the costs of CI for healthcare systems, leading to major rethinking in the field of health cost rationalization. Healthcare financing conditions are fitted to these countries, and differences in healthcare settings influence the results of a cost analysis.…”