Moving beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America

Susan D. Emmett, Debara L. Tucci, Ricardo F. Bento, Juan M. Garcia, Solaiman Juman, Juan A. Chiossone-Kerdel, Ta J. Liu, Patricia Castellanos De Muñoz, Alejandra Ullauri, Jose J. Letort, Teresita Mansilla, Diana P. Urquijo, Maria L. Aparicio, Wenfeng Gong, Howard W. Francis, James E. Saunders

Research output: Contribution to journalArticle

Abstract

Hypothesis: Cochlear implantation (CI) and deaf education are cost effective management strategies of childhood profound sensorineural hearing loss in Latin America. Background: CI has been widely established as cost effective in North America and Europe and is considered standard of care in those regions, yet cost effectiveness in other economic environments has not been explored. With 80% of the global hearing loss burden existing in low- and middle-income countries, developing cost effective management strategies in these settings is essential. This analysis represents the continuation of a global assessment of CI and deaf education cost effectiveness. Methods: Brazil, Colombia, Ecuador, Guatemala, Paraguay, Trinidad and Tobago, and Venezuela participated in the study. A Disability Adjusted Life Years model was applied with 3% discounting and 10-year length of analysis. Experts from each country supplied cost estimates from known costs and published data. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the World Health Organization standard of cost effectiveness ratio/gross domestic product per capita (CER/GDP)<3. Results: Deaf education was very cost effective in all countries (CER/GDP 0.07-0.93). CI was cost effective in all countries (CER/GDP 0.69-2.96), with borderline cost effectiveness in the Guatemalan sensitivity analysis (Max CER/GDP 3.21). Conclusion: Both cochlear implantation and deaf education are widely cost effective in Latin America. In the lower-middle income economy of Guatemala, implant cost may have a larger impact. GDP is less influential in the middle- and high-income economies included in this study.

Original languageEnglish (US)
Pages (from-to)1040-1048
Number of pages9
JournalOtology and Neurotology
Volume37
Issue number8
DOIs
StatePublished - Sep 1 2016

Fingerprint

Cochlear Implantation
Latin America
Cost-Benefit Analysis
Education
Costs and Cost Analysis
Gross Domestic Product
Guatemala
Paraguay
Equipment Failure
Trinidad and Tobago
Ecuador
Venezuela
Colombia
Quality-Adjusted Life Years
Sensorineural Hearing Loss
Salaries and Fringe Benefits
Standard of Care
North America
Hearing Loss
Developing Countries

Keywords

  • Cochlear implantation
  • Cost effectiveness
  • DALY
  • Deaf education
  • Hearing loss
  • Latin America
  • Pediatric

ASJC Scopus subject areas

  • Medicine(all)
  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology

Cite this

Emmett, S. D., Tucci, D. L., Bento, R. F., Garcia, J. M., Juman, S., Chiossone-Kerdel, J. A., ... Saunders, J. E. (2016). Moving beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America. Otology and Neurotology, 37(8), 1040-1048. https://doi.org/10.1097/MAO.0000000000001148

Moving beyond GDP : Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America. / Emmett, Susan D.; Tucci, Debara L.; Bento, Ricardo F.; Garcia, Juan M.; Juman, Solaiman; Chiossone-Kerdel, Juan A.; Liu, Ta J.; De Muñoz, Patricia Castellanos; Ullauri, Alejandra; Letort, Jose J.; Mansilla, Teresita; Urquijo, Diana P.; Aparicio, Maria L.; Gong, Wenfeng; Francis, Howard W.; Saunders, James E.

In: Otology and Neurotology, Vol. 37, No. 8, 01.09.2016, p. 1040-1048.

Research output: Contribution to journalArticle

Emmett, SD, Tucci, DL, Bento, RF, Garcia, JM, Juman, S, Chiossone-Kerdel, JA, Liu, TJ, De Muñoz, PC, Ullauri, A, Letort, JJ, Mansilla, T, Urquijo, DP, Aparicio, ML, Gong, W, Francis, HW & Saunders, JE 2016, 'Moving beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America', Otology and Neurotology, vol. 37, no. 8, pp. 1040-1048. https://doi.org/10.1097/MAO.0000000000001148
Emmett SD, Tucci DL, Bento RF, Garcia JM, Juman S, Chiossone-Kerdel JA et al. Moving beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America. Otology and Neurotology. 2016 Sep 1;37(8):1040-1048. https://doi.org/10.1097/MAO.0000000000001148
Emmett, Susan D. ; Tucci, Debara L. ; Bento, Ricardo F. ; Garcia, Juan M. ; Juman, Solaiman ; Chiossone-Kerdel, Juan A. ; Liu, Ta J. ; De Muñoz, Patricia Castellanos ; Ullauri, Alejandra ; Letort, Jose J. ; Mansilla, Teresita ; Urquijo, Diana P. ; Aparicio, Maria L. ; Gong, Wenfeng ; Francis, Howard W. ; Saunders, James E. / Moving beyond GDP : Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America. In: Otology and Neurotology. 2016 ; Vol. 37, No. 8. pp. 1040-1048.
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