Cost-Effectiveness of Hearing Aids in the Hearing-Impaired Elderly: A Probabilistic Approach
Abstract:
Objective: Hearing aids are the principal tool for rehabilitation of hearing loss, one of the most prevalent impairments among elderly adults, but cost-utility ratings for hearing aid use are limited.
Design: Cost-effectiveness analysis.
Setting and Patients: A multistate Markov model was constructed to model 50- to 80-year-old patients moving between states, including normal hearing, mild, moderate, or severe hearing loss. Parameters assigned in the model are partly derived from the Medline source (1966-2005) and partly from data on hearing-impaired elders (n = 96) in a tertiary care center in Taiwan. To address uncertainty, most of the parameters were specified by distributions, rather than base-case values. A probabilistic approach with Monte Carlo simulations was performed to produce an acceptability curve, showing the probabilities of being cost-effective given threshold values of willingness to pay (WTP).
Main Outcome Measures: Hearing-related quality-adjusted life-years and cost in US dollars and Euros.
Results: The incremental costs for gaining an additional hearing-related quality-adjusted life-years in women and men were US $13,615 (Euro 10,826) and 9,702 (Euro 7,715), respectively. The probability of being cost-effective increased to 53% in women and 65% in men given a WTP of US $12,000 (Euro 9,542). The probabilities of being cost-effective to reach plateau were 67% for women and 78% for men given a WTP of US $20,000 (Euro 15,904).
Conclusion: By modeling different degrees of hearing loss with a multistate model, hearing aid use was demonstrated to be a cost-effective strategy to rehabilitate the hearing-impaired elderly. These results can assist policy makers in allocating health resources appropriately and effectively.
Posted on August 27, 2008, in Uncategorized and tagged aged, economics, hearing aids. Bookmark the permalink. Leave a comment.
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