Cost effectiveness of the multichannel cochlear implant.

Although most third-party payors presently fund cochlear implantation, some do not, and many cite the current lack of cost-effectiveness data as a major concern. Cost-utility analysis is a widely used method of medical technology assessment that permits cost-effectiveness comparisons between medical interventions by determining the cost per quality-adjusted life-year (QALY) they provide. The cost per QALY for the cochlear implant was determined using clinical cost data and a health-utility outcome model based on the established communication gains attained with the device. Cochlear implantation costs approximately $15,600 per QALY provided. Sensitivity analysis, a technique that systematically varies the assumptions underlying the calculations, favorably with other medical interventions, such as coronary artery bypass grafting ($10,431) for three-vessel disease, $64,033 for single-vessel disease), the implantable defibrillator ($29,200), and cardiac transplantation ($38,970). This analysis indicates that the cochlear implant lies well within the cost-effectiveness range currently accepted by the American medical system.