Strategy Total cost Incremental QALY Incremental ICER cost QALY ($/QALY) No intervention $839.48 4.49 VSB $24,848.98 $24,009.50 5.20 0.71 $33,717.99 implantation Source: Calculated during the Critique Abbreviations: ICER, incremental cost-effectiveness ratio; QALY, quality adjusted life year; VSB, Vibrant Soundbridge Table 2 summarises the results of the cost-effectiveness analysis of VSB versus Maxum/Soundtec over the 10-year timeframe. Table 2: Base case results produced by the state-transition model comparing VSB versus Maxum/Soundtec Strategy Total cost Incremental APHAB Incremental ICER cost Global APHAB ($/APHAB) Score Global Score Maxum/Soundtec $13,816.30 400.8 implantation VSB implantation $24,848.98 $11,032.26 300.0 -100.8 $109.46 Source: Calculated during the Critique Abbreviations: APHAB, Abbreviated Profile of Hearing Aid Benefit; ICER, incremental cost-effectiveness ratio; VSB, Vibrant Soundbridge Notes: The APHAB Global Score is scored such that lower scores represent better outcomes. For this reason, a negative incremental score represents a relative benefit. Sensitivity analyses showed the base case model to be reasonably robust, with all univariate analyses resulting in a ratio of less than $50,000 per QALY. MSAC noted that ESC recalculated the primary cost-utility analysis which compared the VSB implant to no treatment as shown in Table 3. Table 3: Base case results comparing VSB versus No intervention Intervention Total Incremental QALYs Incremental ICER cost cost QALYs ($/QALY) No treatment $1,441 3.68 22,175 0.58 37,963.98 VSB $23,616 4.26 implantation Source: Calculated by ESC Financial/budgetary impacts The estimated service numbers associated with the insertion of partially implantable middle ear implants in 2017–2021 are shown in Table 4. Table 4: Estimated eligible population of patients current Description 2017 2018 2019 2020 2021 (2016) Estimated number of Australian adults 855 870 884 899 914 929 eligible for implantation
Strategy Total cost Incremental cost QALY Incremental QALY ICER ($/QALY) No intervention $839.48 4.49 VSB implantation $24,848.98 $24,009.50 5.20 0.71 $33,717.99 Source: Calculated during the Critique Abbreviations: ICER, incremental cost-effectiveness ratio; QALY, quality adjusted life year; VSB, Vibrant Soundbridge Table 2 summarises the results of the cost-effectiveness analysis of VSB versus Maxum/Soundtec over the 10-year timeframe. Table 2: Base case results produced by the state-transition model comparing VSB versus Maxum/Soundtec Strategy Total cost Incremental cost APHAB Global Score Incremental APHAB Global Score ICER ($/APHAB) Maxum/Soundtec implantation $13,816.30 400.8 VSB implantation $24,848.98 $11,032.26 300.0 -100.8 $109.46 Source: Calculated during the Critique Abbreviations: APHAB, Abbreviated Profile of Hearing Aid Benefit; ICER, incremental cost-effectiveness ratio; VSB, Vibrant Soundbridge Notes: The APHAB Global Score is scored such that lower scores represent better outcomes. For this reason, a negative incremental score represents a relative benefit. Sensitivity analyses showed the base case model to be reasonably robust, with all univariate analyses resulting in a ratio of less than $50,000 per QALY. MSAC noted that ESC recalculated the primary cost-utility analysis which compared the VSB implant to no treatment as shown in Table 3. Table 3: Base case results comparing VSB versus No intervention Intervention Total cost Incremental cost QALYs Incremental QALYs ICER ($/QALY) No treatment $1,441 22,175 3.68 0.58 37,963.98 VSB implantation $23,616 4.26 Source: Calculated by ESC Financial/budgetary impacts The estimated service numbers associated with the insertion of partially implantable middle ear implants in 2017–2021 are shown in Table 4. Table 4: Estimated eligible population of patients Description current (2016) 2017 2018 2019 2020 2021 Estimated number of Australian adults eligible for implantation 855 870 884 899 914 929
FINAL_PSD-1365.1_Active_middle_ear_implants_for_sensorineural_hearing-Accessible.docx