Cost effectiveness of cochlear implants.

Abstract

Health professionals would be well served to have as good an understanding of cost effectiveness as clinical effectiveness, as both are critical to their patients having access to better health care and achieving better health outcomes. Cost-effectiveness evaluations allow decision makers a means of comparing different interventions when deciding resource allocation. It is a powerful tool, but like any analysis, not understanding the processes and assumptions involved leads to misinterpretation. Cost effectiveness is an economic evaluation of cost and benefit. The threshold at which an intervention is considered cost effective is reflected by the payer's "willingness to pay", which can vary considerably from country to country. These evaluations are complex and can involve the use of incomplete financial data, and subjective impressions of benefit, while excluding broader social and economic benefits. Pediatric unilateral and simultaneous bilateral cochlear implantation, and adult unilateral cochlear implantation are felt to be cost effective in the United States. Pediatric sequential cochlear implantation, adult bilateral cochlear implantation, implantation in the aged and the long deaf are not. However, cost-effectiveness economic evaluations are only part of broader assessment of social and economic benefit when determining resource allocation.