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Ad F. M. Snik, PhD; Noortje T. L. van Duijnhoven, MSc; Emmanuel A. M. Mylanus, MD, PhD; Cor W. R. J. Cremers, MD, PhD

Arch Otolaryngol Head Neck Surg. 2006;132:1210-1215.

Objective  To determine the cost-effectiveness of middle-ear implantations in hearing-impaired patients with severe external otitis in the Netherlands.

Design  Cost-effectiveness analysis, using single-subject repeated measures of quality of life and total cost determinations.

Setting  Hospital based.

Patients  Moderately to severely sensorineurally hearing-impaired patients (n = 21) with severe chronic external otitis, eligible to receive a middle-ear implant.

Main Outcome Measure  Cost per quality-adjusted life-year (QALY), based on scores of the Medical Outcomes Study Short-Form HealthSurvey (SF-36) generic quality of life questionnaire. Only direct costs were included in cost calculation of middle-ear implantation.

Results  Mean health utility gain was 0.046 (0.012-0.079) (P = .01) measured at the mental component of the SF-36. With a mean profitable time of 19.4 years and an overall cost of 14 354, minimal cost-effectiveness of middle-ear implantation was 16 085/QALY.

Conclusion  Based on the cost per QALY, middle-ear implantation proved to be a cost-effective and justified health care intervention in the Netherlands.

Author Affiliations: Department of Otorhinolaryngology, University Medical Center St Radboud Nijmegen, Nijmegen, the Netherlands.