Cost-utility analysis of cochlear implants in Korea using different measures of utility.
CONCLUSIONS
All cost-utility ratios obtained using the various measures of utility except quality well-being (QWB) were below 25,000 dollars per quality-adjusted life year (QALY). Therefore, treatment of post-lingual deaf adults with cochlear implants improves the quality of life at a reasonable direct cost and appears to produce net savings for Korean society.


OBJECTIVE
To determine the quality of life and the cost consequences of cochlear implants for deaf adults.


METHODS
We performed a cost-utility analysis using data from 11 post-lingual deaf adults who had received cochlear implants between 1990 and 2002 in Seoul, Korea. The average age of the participants was 49.6 years. The main outcome was the direct cost per QALY calculated using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D) measure and QWB measure. Costs and utility were discounted 3% annually.


RESULTS
Recipients used implants for an average of 5.6 years. The mean VAS, HUI, EQ-5D, and QWB score increased by 0.33 (from 0.27 before implantation to 0.60 at survey), 0.36 (0.29 to 0.65), 0.26 (0.52 to 0.78), and 0.16 (0.45 to 0.61), respectively. The discounted direct cost was 22,320 dollars, which yielded a cost-utility ratio of 19,223 dollars per QALY using VAS, 17,387 dollars per QALY using HUI, 24,604 dollars per QALY using EQ-5D, and 40,474 dollars per QALY using QWB.
Lee
Hoo-Yeon
HY
Graduate School of Public Health, Yonsei University, South Korea.
Park
Eun-Cheol
EC
Kim
Han Joong
HJ
Choi
Jae-Young
JY
Kim
Hee-Nam
HN
D000328:Adult; D003054:Cochlear Implants / Q000191:economics* / Q000523:psychology; D003362:Cost-Benefit Analysis / Q000191:economics*; D003431:Cross-Cultural Comparison; D003638:Deafness / Q000191:economics* / Q000523:psychology / Q000534:rehabilitation*; D004180:Direct Service Costs / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology; D019057:Quality-Adjusted Life Years