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Video

Business of Medicine

(A002) Cost-Benefit Analysis of Pediatric Bilateral Cochlear Implantation in Taiwan

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • TF

    Te-Yung Fang, MD

    Attending Physician
    Cathay General Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

  • CL

    Chih-Hsien Liu, MD

    Attending Physician
    Department of Otolaryngology Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan
    Taipei, Taipei, Taiwan (Republic of China)

  • Pei-Hsuan Lin, MD

    Attending Physician
    National Taiwan University Hospital
    Taipei City, Taipei, Taiwan (Republic of China)

    • Senior Author(s)

  • Pa-Chun Wang, MD, PhD

    Professor
    Cathay General Hospital
    Taipei, Taipei, United States

    • Co-Author(s)

  • CW

    Chen-Chi Wu, MD, PhD

    Professor
    National Taiwan University Hospital
    Taipei, Taipei, Taiwan (Republic of China)

Disclosure(s):
Te-Yung Fang, MD: No relevant relationships to disclose.
Chih-Hsien Liu, MD: No relevant relationships to disclose.
Pei-Hsuan Lin, MD: No relevant relationships to disclose.


Introduction: This study evaluates the cost-benefit analysis of pediatric bilateral cochlear implantation in children with severe to profound sensorineural hearing loss (SNHL), focusing on outcomes prior to entering adulthood.

Methods: A retrospective analysis was conducted on children with bilateral SNHL who received bilateral CIs(CICI), categorized into early sequential, early simultaneous, and late CICI implantation groups. The total cost analysis included direct medical expenses, educational costs, social welfare allowances, and family out-of-pocket expenses.

Benefits were quantified as the product of quality-adjusted life years (QALYs) and willingness-to-pay (WTP), with WTP equated to Taiwan’s GDP per capita. Net present value (NPV) was calculated as the difference between total benefits and costs over an 18-year period, adjusted for discounting.

Results: The “early CICI simultaneous” group incurred the highest total costs (USD 348594), exceeding those of the “early CICI sequential” group by USD 20000 and the “late CICI” group by USD35000. Despite higher costs, all CICI group achieved the high QALY gains, resulting in a positive NPV under a WTP threshold equivalent to Taiwan’s GDP per capita.

Conclusions: Cost-benefit analysis demonstrated a positive NPV for all groups, using a WTP threshold equal to one times the GDP per capita. Educational costs accounted for the largest share of total expenses. From both medical and economic perspectives, bilateral implantation is recommended for children with bilateral severe to profound SNHL to maximize benefits and reduce long-term societal burdens.