- Title
- A multinational cost-consequence analysis of a bone conduction hearing implant system - a randomized trial of a conventional vs. a less invasive treatment with new abutment technology
- Creator
- van Hoof, Marc; Wigren, Stina; van Tongeren, Joost; Hof, Janny R.; Brunings, Jan Wouter; Anteunis, Lucien J. C.; Marco Algarra, Jaime; Stokroos, Robert Jan; Joore, Manuela A.; Ivarsson Blechert, Johan; Molin, Mattias; Andersson, Henrik; Mateijsen, D. J. M.; Bom, Steven J. H.; Calmels, M. N.; van der Rijt, Antoon J. M.; Flynn, Mark C.
- Relation
- Frontiers in Neurology Vol. 11, Issue 13 March 2020, no. 106
- Publisher Link
- http://dx.doi.org/10.3389/fneur.2020.00106
- Publisher
- Frontiers Research Foundation
- Resource Type
- journal article
- Date
- 2020
- Description
- Background: It is hypothesized that, for patients with hearing loss, surgically placing an implant/abutment combination whilst leaving the subcutaneous tissues intact will improve cosmetic and clinical results, increase quality of life (QoL) for the patient, and reduce medical costs. Here, incremental costs and consequences associated with soft tissue preservation surgery with a hydroxyapatite (HA)-coated abutment (test) were compared with the conventional approach, soft tissue reduction surgery with an all-titanium abutment (control). Methods: A cost-consequence analysis was performed based on data gathered over a period of 3 years in an open randomized (1:1) controlled trial (RCT) running in four European countries (The Netherlands, Spain, France, and Sweden). Subjects with conductive or mixed hearing loss or single-sided sensorineural deafness were included. Results: During the first year, in the Netherlands (NL), France (FR), and Spain (ES) a net cost saving was achieved in favor of the test intervention because of a lower cost associated with surgery time and adverse event treatments [NL €86 (CI −50.33; 219.20), FR €134 (CI −3.63; 261.30), ES €178 (CI 34.12; 97.48)]. In Sweden (SE), the HA-coated abutment was more expensive than the conventional abutment, which neutralized the cost savings and led to a negative cost (SE €-29 CI −160.27; 97.48) of the new treatment modality. After 3 years, the mean cost saving reduced to €17 (CI −191.80; 213.30) in the Netherlands, in Spain to €84.50 (CI −117.90; 289.50), and in France to €80 (CI −99.40; 248.50). The mean additional cost in Sweden increased to €-116 (CI −326.90; 68.10). The consequences in terms of the subjective audiological benefit and Health-related quality of life (HRQoL) were comparable between treatments. A trend was identified for favorable results in the test group for some consequences and statistical significance is achieved for the cosmetic outcome as assessed by the clinician. Conclusions: From this multinational cost-consequence analysis it can be discerned that health care systems can achieve a cost saving during the first year that regresses after 3 years, by implementing soft tissue preservation surgery with a HA-coated abutment in comparison to the conventional treatment. The cosmetic results are better. (sponsored by Cochlear Bone Anchored Solutions AB; Clinical and health economic evaluation with a new Baha® abutment design combined with a minimally invasive surgical technique, ClinicalTrials.gov NCT01796236).
- Subject
- RCT - randomized controlled trial; cost consequence analysis; HTA (health technology assessment); BAHA; bone conducting device; skin integration
- Identifier
- http://hdl.handle.net/1959.13/1425484
- Identifier
- uon:38255
- Identifier
- ISSN:1664-2295
- Rights
- © 2020 van Hoof, Wigren, Ivarsson Blechert, Molin, Andersson, Mateijsen, Bom, Calmels, van der Rijt, Flynn, Tongeren, Hof, Brunings, Anteunis, Marco Algarra, Stokroos and Joore. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
- Language
- eng
- Full Text
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