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Longitudinal economic analysis of Bonebridge 601 versus percutaneous bone‐anchored hearing devices over a 5‐year follow‐up period
Author(s) -
Amin Nikul,
Soulby Andrew Jonathan,
Borsetto Daniele,
Pai Irumee
Publication year - 2021
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13659
Subject(s) - medicine , implant , percutaneous , hearing loss , patient satisfaction , surgery , complication , longitudinal study , audiology , pathology
Objectives Percutaneous bone‐anchored hearing devices (pBAHDs) are the most commonly used bone conduction implants (BCI). Concerns surround the long‐term complications, notably skin‐related, in patients with percutaneous abutments. The active transcutaneous BCI Bonebridge system can help avoid some of these pitfalls but is often considered a second‐line option due to various factors including perceived increased overall costs. Design Longitudinal economic analysis of Bonebridge BCI 601 versus pBAHD over a 5‐year follow‐up period. Setting A specialist hearing implant centre. Participants Adult patients (≥16 years) with conductive hearing loss, mixed hearing loss or single‐sided deafness, who received a Bonebridge or pBAHD implant between 1/7/2013 and 1/12/2018 with a minimum 12‐month follow‐up. Main outcome measures We compared the mean costs per implanted patient for both implants at 1, 3 and 5 years postoperative time points. Clinical effectiveness was evaluated using objective and patient‐reported outcome measures. Results The mean total cost per patient of Bonebridge was significantly higher than pBAHD at 1‐year post‐implantation (£8512 standard deviation [SD] £715 vs £5590 SD £1394, P < .001); however, by 5‐years post‐implantation this difference was no longer statistically significant (£12 453 SD £2159 vs £12 575 SD £3854, P > .05). The overall cost convergence was mainly accounted for by the increased long‐term complications, revision surgery rates and higher cost of the pBAHD external processor compared to Bonebridge. Conclusions Long‐term costs of Bonebridge to healthcare providers are comparable to pBAHDs, whilst offering lower complication rates, comparable audiological benefit and patient satisfaction. Bonebridge should be considered as a first‐line BCI option in appropriate cases.