Cost-Effectiveness of Unilateral Cochlear Implants in Chinese Adults: Decision Analytical Modeling.

OBJECTIVE: This study aimed to evaluate the cost-effectiveness of unilateral cochlear implants (UCIs) in Chinese adults with severe or profound sensorineural hearing loss, which helps to inform the introduction of a new intervention for underserved adult patients with severe hearing loss. STUDY DESIGN: Cost-effectiveness analysis. SETTING: Six tertiary hospitals located in north, east, south, and west China, designated as National Regional Medical Centers or WHO Collaborating Centers for the Prevention of Deafness. METHODS: Using a Markov model, we conducted cost effectiveness analysis over the patient's lifetime and from the perspective of the Chinese healthcare system. Costs and outcomes are discounted by 5% annually. Compared with the control measures of hearing aids (HAs), interventions for UCIs include surgery, rehabilitation, regular maintenance, and periodic replacements. RESULTS: The incremental cost of UCIs versus HAs was 216,414.37 CNY, which was accompanied by an incremental utility value of 3.34 QALYs. Therefore, UCIs demonstrated superior cost-effectiveness compared with HAs. The incremental cost-effectiveness ratio (ICER) was 64,794.72 Chinese yuan (CNY)/quality-adjusted life years (QALY), indicating that the cost required to gain one additional QALY was 64,794.72 CNY. The ICER was below the World Health Organization-recommended threshold of 1 to 3 times the GDP per capita (China's 2022 GDP per capita range = 85,698-257,094 CNY) and falls within 47% to 88% of the per capita GDP (research estimates 77%). Sensitivity analyses and age-based scenario analyses indicated good stability of the results. CONCLUSIONS: UCIs are a cost-effective intervention for adults in China.