Table 3.

IMD costs and disutilities

Complication	Direct medical costsa	Sources	Productivity costsa	Sources	Disutility	Sources
Uncomplicated disease	$14,918		$2988	De Wals et al. (2007)	− 0.0317b	Ginsberg et al. (2016)
Scarring	$9347	OCCI (2016)	$0	Assumed	− 0.08	Bijlard et al. (2017)
Amputation	$22,070	OCCI (2016)	≤ 24 years: $244,136c 25–59 years: $136,124 ≥ 60 years: $14,493	Rancourt et al. (2003)	− 0.32	Shepard et al. (2005)
Paralysis	$6559	OCCI (2016)	$0	No data available	− 0.32	Assumed equal to amputation
Seizure/epilepsy	$11,028	OCCI (2016)	$0	No data available	− 0.053	Ginsberg et al. (2016)
Hearing loss	$0	No data available	$64,758d	Chen et al. (2014)	− 0.033	Ginsberg et al. (2016)
Neurologic sequelae	$8743	OCCI (2016)	≤ 24: $1,220,682e 25–59: $680,621 ≥ 60: $72,463	Shepard et al. (2005)	− 0.56	Oostenbrink et al. (2002)
Renal failure	$12,047	OCCI (2016)	$0	No data available	− 0.107	Ginsberg et al. (2016); Murray and Lopez (1996)
Death	$0		≤ 24: $1,220,682f 25–59: $680,621 ≥ 60: $72,463	Gu and Wong (2010)	− 1

^aCosts reported in 2015 Canadian dollars

^bAcute disutility; all IMD complications are assumed to have lifelong disutility

^c20% of lifetime productivity loss

^dUnilateral cochlear implant cost (surgical, preoperative, and postoperative) with 25-year time horizon

^e100% of lifetime productivity loss

^fLifetime productivity loss