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中国成人单侧人工耳蜗的成本效益：决策分析模型

Cost-Effectiveness of Unilateral Cochlear Implants in Chinese Adults: Decision Analytical Modeling.

临床研究耳科IF 2.9Q1

文献信息

PMID42735054
原文在 PubMed 查看原文 ↗
发表日期2026
作者Di Wu
查看其他 7 位作者

Yingpeng Qiu；Yue Xiao；Alec Morton；Huanhuan Xu；Shiyu Wei；Junrui Pei；Wenqi Fu

作者单位Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
查看其他 5 条单位信息

Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.；Department of Medicine and Health Technology Assessment and Innovation Development, China National Health Development Research Center (National Center for Medicine and Health Technology Assessment), Beijing, China.；School of Medicine and Population Health, The University of Sheffield, Sheffield, England, UK.；Management Science, Strathclyde Business School, University of Strathclyde, Glasgow, Scotland, UK.；Public Health College, Qiqihar Medical University, Qiqihar, Heilongjiang, China.

期刊Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
SCI 分区Q1
IF2.9
研究类型临床研究 · 临床
所属专科耳科

中文摘要

目的： 本研究旨在评估单侧人工耳蜗（UCIs）在中国重度或极重度感音神经性听力损失成人中的成本效益，有助于为服务不足的重度听力损失成人患者引入新干预措施提供信息。
研究设计： 成本效益分析。
地点： 位于中国北部、东部、南部和西部的六家三级医院，被指定为国家区域医疗中心或世界卫生组织防聋合作中心。
方法： 使用马尔可夫模型，我们从中国医疗系统的角度对患者的终生进行了成本效益分析。成本和结果按每年5%贴现。与助听器（HAs）的对照措施相比，UCIs的干预措施包括手术、康复、定期维护和周期性更换。
结果： UCIs相对于HAs的增量成本为216,414.37元人民币，同时伴随3.34个质量调整生命年（QALYs）的增量效用值。因此，与HAs相比，UCIs表现出更优的成本效益。增量成本效益比（ICER）为64,794.72元人民币（CNY）/质量调整生命年（QALY），表明获得一个额外QALY所需的成本为64,794.72元人民币。ICER低于世界卫生组织推荐的1至3倍人均GDP阈值（中国2022年人均GDP范围=85,698-257,094元人民币），并处于人均GDP的47%至88%之间（研究估计为77%）。敏感性分析和基于年龄的情景分析表明结果具有良好的稳定性。
结论： UCIs对中国成人是一种具有成本效益的干预措施。

英文摘要

OBJECTIVE: This study aimed to evaluate the cost-effectiveness of unilateral cochlear implants (UCIs) in Chinese adults with severe or profound sensorineural hearing loss, which helps to inform the introduction of a new intervention for underserved adult patients with severe hearing loss.
STUDY DESIGN: Cost-effectiveness analysis.
SETTING: Six tertiary hospitals located in north, east, south, and west China, designated as National Regional Medical Centers or WHO Collaborating Centers for the Prevention of Deafness.
METHODS: Using a Markov model, we conducted cost effectiveness analysis over the patient's lifetime and from the perspective of the Chinese healthcare system. Costs and outcomes are discounted by 5% annually. Compared with the control measures of hearing aids (HAs), interventions for UCIs include surgery, rehabilitation, regular maintenance, and periodic replacements.
RESULTS: The incremental cost of UCIs versus HAs was 216,414.37 CNY, which was accompanied by an incremental utility value of 3.34 QALYs. Therefore, UCIs demonstrated superior cost-effectiveness compared with HAs. The incremental cost-effectiveness ratio (ICER) was 64,794.72 Chinese yuan (CNY)/quality-adjusted life years (QALY), indicating that the cost required to gain one additional QALY was 64,794.72 CNY. The ICER was below the World Health Organization-recommended threshold of 1 to 3 times the GDP per capita (China's 2022 GDP per capita range = 85,698-257,094 CNY) and falls within 47% to 88% of the per capita GDP (research estimates 77%). Sensitivity analyses and age-based scenario analyses indicated good stability of the results.
CONCLUSIONS: UCIs are a cost-effective intervention for adults in China.