Cost-utility analysis of cochlear implants in Korea using different measures of utility

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Abstract
Conclusions. All cost-utility ratios obtained using the various measures of utility except quality well-being (QWB) were below $25 000 per quality-adjusted life year (QALY). Therefore, treatment of post-lingual deaf adults with cochlear implants improves the quality of life at a reasonable direct cost and appears to produce net savings for Korean society. Objectives. To determine the quality of life and the cost consequences of cochlear implants for deaf adults. Patients and methods. We performed a cost-utility analysis using data from 11 post-lingual deaf adults who had received cochlear implants between 1990 and 2002 in Seoul, Korea. The average age of the participants was 49.6 years. The main outcome was the direct cost per QALY calculated using the visual analog scale (VAS), health utility index (HUI), EuroQol (EQ-5D) measure and QWB measure. Costs and utility were discounted 3% annually. Results. Recipients used implants for an average of 5.6 years. The mean VAS, HUI, EQ-5D, and QWB score increased by 0.33 (from 0.27 before implantation to 0.60 at survey), 0.36 (0.29 to 0.65), 0.26 (0.52 to 0.78), and 0.16 (0.45 to 0.61), respectively. The discounted direct cost was $22 320, which yielded a cost-utility ratio of $19 223 per QALY using VAS, $17 387 per QALY using HUI, $24 604 per QALY using EQ-5D, and $40 474 per QALY using QWB.