Otology & Neurotology

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Otology & Neurotology:
doi: 10.1097/MAO.0000000000000331
Sensorineural Hearing Loss & Tinnitus

Cost-Effectiveness of Specialized Treatment Based on Cognitive Behavioral Therapy Versus Usual Care for Tinnitus

Maes, Iris H. L.*†‡; Cima, Rilana F. F.†‡; Anteunis, Lucien J. C.§∥; Scheijen, Dyon J. W. M.; Baguley, David M.; El Refaie, Amr#; Vlaeyen, Johannes W.**‡; Joore, Manuela A.*††

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Objective: To evaluate the cost-effectiveness of specialized multidisciplinary tinnitus treatment based on cognitive behavioral therapy, compared with care as usual.

Design: Randomized controlled trial including an economic evaluation from a health-care and societal perspective, using a one-year time horizon.

Setting: Audiologic center.

Patients: A referred sample of 626 patients with tinnitus were eligible for participation. Approximately 492 patients were included in the study. Eighty-six (35%) of 247 patients in the usual care group, and 74 (30%) of 245 patients in the specialized care group were lost to follow-up by month 12.

Main Outcome Measures: Quality adjusted life years (QALYs) as measured with the Health Utilities Index Mark III and cost in US dollars.

Results: Compared with patients receiving usual care, patients who received specialized care gained on average 0.015 QALYs (95% bootstrapped confidence interval [BCI], −0.03 to 0.06). The incremental costs from a societal perspective are $357 (95% BCI,−$1,034 to $1,785). The incremental cost per QALY from a societal perspective amounted to $24,580. The probability that SC is cost-effective from a societal perspective is 58% for a willingness to pay for a QALY of $45,000.

Conclusion: Specialized multidisciplinary tinnitus treatment based on cognitive behavioral therapy is cost-effective as compared with usual care. Although uncertainty surrounding the incremental costs and effects is considerable, sensitivity analysis indicated that cost-effectiveness results were robust.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company

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