Table 6.

Economic Burden of Vestibular Loss in Older Adults and Sensitivity Analysis

	Symptomatic Vestibular Loss Prevalencea	Affected Populationb	Average QALYs Lostc	Population QALYs Lostd	$/QALYe	Individual Burdenf	Societal Burden (billion)g
Base Case
60–69 years	0.07	1,164,166	1.82	2,124,388	$50,000	$91,241	$106.22
70–79 years	0.09	1,105,494	1.43	1,585,227	$50,000	$71,698	$79.26
>=80 years	0.11	1,077,104	0.77	826,426	$50,000	$38,363	$41.32
Total	0.08	3,346,764	1.30	4,346,050	$50,000	$64,929	$226.80

	Base Estimate	Range of Estimate (Lowest to Highest)	60–69 years (Base $91,241)	70–79 years (Base $71,698)	>=80 years (Base $38,363)	Overall Individual Burden (Base $64,929)	Societal Burden (Base $226.80 billion)
Sensitivity Analysis
Variables
Discount rate	3%	0–6	$72,547‐$118,375	$61,571‐$84,994	$34,781‐$42,583	$55,080‐$78,275	$189.99‐$277.63
Annual HUI Loss	0.15	0.10‐0.20	$65,827‐$131,654	$52,382‐$104,764	$30,576‐$61,151	$48,101‐$96,202	$167.47‐$334.95
Average Prevalence	0.08	0.07‐0.10a	Unchanged	Unchanged	Unchanged	Unchanged	$283.10‐$404.42
$/QALY	$50,000	$25,000‐$75,000e	$45,620‐$136,861	$35,849‐$107,546	$19,182‐$57,545	$32,465‐$97,394	$113.40‐$340.20

Abbreviations: QALY, Quality‐Adjusted Life Year

^aUsing an average of literature‐derived prevalence of vestibular vertigo with relative age‐category weights from Agrawal et al (2009).

^bDerived using 2013 US Census data stratified by age; www.census.gov.

^cUsing an annual health‐utility loss of 0.15 at a discount rate of 3% across the years to life expectancy in the vestibular loss study group

^dProduct of discounted average QALYs lost and affected population

^eUsing highly conservative Willingness‐to‐Pay (WTP) thresholds derived from Hirth et al. (2000).

^fLifetime Economic Burden of vestibular loss per Affected Individual, product of Population QALYs Lost and $/QALY divided by Affected Population

^gLifetime Societal Burden of vestibular loss, product of Population QALYs Lost and $/QALY