Brunner Matthias, Schou Manjula, Briggs Robert J, Kingsford Smith Dell
Cochlear Limited, Macquarie University, Sydney, NSW 2109, Australia;
Departments of Surgery and Otolaryngology, University of Melbourne, Parkville, VIC 3052, Australia.
J Mark Access Health Policy. 2024 Mar 6;12(1):5-20. doi: 10.3390/jmahp12010003. eCollection 2024 Mar.
The aim of this study was to evaluate the comparative clinical effectiveness and cost-utility of the active transcutaneous Osia System versus the passive transcutaneous Baha Attract System for patients with conductive or mixed hearing loss or single-sided deafness in an Australian healthcare setting. In the absence of direct comparative evidence, an indirect treatment comparison (ITC) of the clinical effectiveness and utility gains was needed. The ITC was informed by three studies identified through a systematic literature review. A Markov model was developed to evaluate the cost-utility of the Osia System. The literature review identified three studies suitable to inform an ITC: Mylanus et al. 2020 and Briggs et al. 2022 (Osia System) and den Besten et al. 2019 (Baha Attract System). The Osia System was found to be clinically superior to the Baha Attract System, across objective audiological outcomes resulting in a clinically meaningful utility benefit of 0.03 measured by the Health Utility Index with at least equivalent safety. In conclusion, the Osia System is more effective than the Baha Attract System, providing better hearing and health-related quality of life outcomes. In an Australian healthcare setting, the Osia System is cost-effective as demonstrated in a cost-utility analysis versus the Baha Attract System.
本研究的目的是在澳大利亚医疗环境中，评估主动式经皮Osia系统与被动式经皮Baha Attract系统对传导性或混合性听力损失或单侧耳聋患者的相对临床疗效和成本效益。由于缺乏直接的比较证据，因此需要对临床疗效和效用增益进行间接治疗比较（ITC）。通过系统文献综述确定的三项研究为ITC提供了依据。开发了一个马尔可夫模型来评估Osia系统的成本效益。文献综述确定了三项适合为ITC提供依据的研究：Mylanus等人（2020年）和Briggs等人（2022年）（关于Osia系统）以及den Besten等人（2019年）（关于Baha Attract系统）。研究发现，在客观听力学结果方面，Osia系统在临床上优于Baha Attract系统，通过健康效用指数测量，其临床意义上的效用效益为0.03，且安全性至少相当。总之，Osia系统比Baha Attract系统更有效，能提供更好的听力和与健康相关的生活质量结果。在澳大利亚医疗环境中，与Baha Attract系统相比，成本效益分析表明Osia系统具有成本效益。
