SOCIO-ECONOMIC IMPACT OF COCHLEAR IMPLANTATION IN ADULTS: AN ITALIAN STUDY| ACTA Otorhinolaryngologica Italica
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Published: 2025-09-23

SOCIO-ECONOMIC IMPACT OF COCHLEAR IMPLANTATION IN ADULTS: AN ITALIAN STUDY

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy
University of Trieste
Department of Economic, Business, Mathematical and Statistical Sciences 'Bruno de 'Finetti', University of Trieste, Trieste, Italy
Department of Economic, Business, Mathematical and Statistical Sciences 'Bruno de 'Finetti', University of Trieste, Trieste, Italy.
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.
ENT Department, Maggiore Hospital, Lodi, Italy.
Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy
Cochlear implants; Quality-Adjusted Life Years; Cost-Effectiveness Analysis; hearing loss

Abstract

Objective: To analyze the cost-effectiveness of unilateral cochlear implant (CI) surgery in Italian adults with post-lingual deafness, focusing on direct costs, Health Utilities Index (HUI), Quality-Adjusted Life Years (QALY), and Incremental Cost-Effectiveness Ratio (ICER).

Methods: The analysis, from the Italian healthcare system perspective, included preoperative, surgical, hospitalization, and postoperative costs. QALYs were estimated using the Italian Nijmegen Cochlear Implant Questionnaire (I-NCIQ) and Ontario Health Utilities Index Mark 3 (HUI-3). HUI-3 score changes were analyzed with regression models in Stat View (v5.0.1, SAS Institute Inc). ICER was calculated as the incremental cost per QALY (in Euros/QALY) over the average patient’s lifetime.

Results: CI significantly improved I-NCIQ (P < .001) and HUI-3 scores (P < .0001). Average life expectancy at surgery was 21.29 years; the degrade factor was 0.97, yielding a lifetime gain of 2.717 QALYs. Direct costs amount to €19,467.65. Cost-utility analysis showed €7,165.13 per QALY, below the €30,000/QALY ICER threshold.

Conclusions: CI surgery is cost-effective based on QALY analysis. Although cost-effectiveness decreases with age, quality of life and health benefits are comparable to younger patients.

Affiliations

Annalisa Gatto

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy

Margherita Tofanelli

University of Trieste

Giorgio Valentinuz

Department of Economic, Business, Mathematical and Statistical Sciences 'Bruno de 'Finetti', University of Trieste, Trieste, Italy

Ludovico Carrino

Department of Economic, Business, Mathematical and Statistical Sciences 'Bruno de 'Finetti', University of Trieste, Trieste, Italy.

simone zucchini

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.

Egidio Sia

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.

Francesco Uderzo

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy.

Vittorio Pietro Achilli

ENT Department, Maggiore Hospital, Lodi, Italy.

Giancarlo Tirelli

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, 34149 Trieste, Italy

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Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2025

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