Table A12:
Selected Results From Scenario Analyses: Public Payer Scenario and Lower and Upper Range of Incremental Cost-Effectiveness Ratios
| Economic Model | Scenario | ICER, $/QALY |
|---|---|---|
| Model 1, adults | Reference case | 18,148 |
| Lower ICER: lifetime time horizon and increased risk of mortality associated with no intervention | 13,165 | |
| Upper ICER: mean difference in utilities based on time trade-off method | 55,655 | |
| Public payer,a plus 100% receiving rehabilitation (2 one-hour sessions) | 20,237 | |
| Model 1, children | Reference case | 17,783 |
| Lower ICER: lifetime time horizon and increased risk of mortality associated with no intervention | 11,293 | |
| Upper ICER: mean difference in utilities based on time trade-off method | 54,038 | |
| Public payer,a 100% receiving rehabilitation (weekly for 18 months) | 20,645 | |
| Model 2, adults | Reference case | 408,350 |
| Lower ICER: age of implantation at 80 years and increased risk of mortality associated with no intervention | 29,071 | |
| Upper ICER: ADP pays for full price of sound processor replacements | 450,927 | |
| Public payera | 404,732 | |
| Model 2: children | Reference case | 402,899 |
| Lower ICER: utilities based on literature | 43,842 | |
| Upper ICER: disutilities applied to all complications | 2,277,930 | |
| Public payera | 477,640 | |
| Model 3, adults | Reference case | 74,155 |
| Lower ICER: lifetime time horizon and increased risk of mortality associated with no intervention | 24,730 | |
| Upper ICER: ADP pays for full price of sound processor replacements | 90,372 | |
| Public payera | 81,104 | |
| Model 3: children | Reference case | 87,580 |
| Lower ICER: utilities based on literature | 34,054 | |
| Upper ICER: disutilities applied to all complications | 105,569 | |
| Public payera | 91,591 |
Abbreviations: ADP, assistive devices program; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year.
a
In the public payer scenario, the Ministry of Community and Social Services pays the remainder of the sound processor replacement cost not covered by the Ministry of Health's Assistive Devices Program, in the 40% of individuals who are considered low-income.
Note: Model 1 examined cochlear implants for single-sided deafness; Model 2, bone-conduction implants for single-sided deafness; Model 3, bone-conduction implants for conductive/mixed hearing loss.