Tuesday, October 20, 2020

Longitudinal economic analysis of Bonebridge 601 versus percutaneous bone anchored hearing devices over a 5‐year follow‐up period

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Abstract

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 1/7/2013‐1/12/2018 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 post‐operative 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 (£8,512 standard deviation [SD] £715 vs £5,590 SD £1,394, p<0.001); however, by 5‐years post‐implantation this difference was no longer statistically significant (£12,453 SD £2,159 vs £12,575 SD £3,854, p>0.05). 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.

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