Research: Cost effectiveness of bilateral cochlear implants

11 10 2010

Can you help with some vital research that started at the University of York in Oct/Nov 2009?

The NICE Guidance issued in Jan 2009 stopped short of recommending bilateral implants for adults. However, the Guidance recommended that further research should be carried out to establish the cost effectiveness of bilateral implants for adults and that this should be done in time for the next NICE Review which will start in February 2011.

Professor Quentin Summerfield is seeking volunteers with unilateral or bilateral implants to participate in evaluating new tests and apparatus in the pilot phase of this all important research project.

Volunteers would need to travel to York to take part but expenses will be refunded and, for those travelling from afar, the costs of accommodation will also be covered with a subsistence allowance.

If you are able to help, send an e-mail message to p.kitterick@psych.york.ac.uk, or get in touch by phone (Padraig Kitterick : 01904 432 883; Quentin Summerfield; 01904 432 913).

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7 responses

11 10 2010
Catherine Mellor

This sounds very much like a worthwhile study. It would be good to know the difference it makes in comprehending speech if one is bilaterally implanted. The social handicap from not being able to do so are enormous. I am happy to report that even with just one side implanted I am comprehending more and more speech each day without lipreading, like simple conversations in the car in the dark! 🙂 This from someone who has lip-read all her life!

21 10 2010
sammarcko

It’s always about cost effectiveness. It’s always about money. Money. Money. Money. Like everything. The benefits of two implants are there (maybe not for everyone- but certainly for plenty of people) Sometimes it drives me to pull what’s left of my hair out. Some of these Medical Insurers and surgeons can’t always see the woods for the trees. I have one insurer which has protocols stating they will only approve bilaterals on newborns or on those up to age 4 post menegitis. I have other medical insurers who will approve one implants partial costs per calender year. None of these insurers cover the costs of any implant 100% They cover maybe 50% of the device and 100% of the hospital. Yet if you request a simultaneous bilateral they will say NO (Never mind the cost savings to the insurers -one surgery instead of two, discounted implants (second implants are usuallly discounted hereabouts) or even consider the surgeons valuable time. (S/he has to trudge back to the hospital to place a second implant the next calender year in the same patient-when S/he could be spending time implanting a new patient) ) Implant surgeons aren’t a dime a dozen and you can’t pluck them off a tree when you need one. And if you want a bilateral, as Tina says – you need to pay out of your own pocket and hereabouts the insurers will simply not cover the extra costs of Hospital time- that’s for your own account too. Tell me where is the logic in all this?
Surgeons sometimes are asked to motivate insurers for bilaterals in Adults and this is plain wrong because they are being asked to make quality of life decisions regarding the technology. They are surgeons for gods sake, not engineers or consumer advocates. This is plain wrong that they are asked to do so. It’s not their job and the insurers should not require quality of life motivations from surgeons for bilateral.
A word of caution for those of you privately seeking implants in India. I have it on good authority from one manufacturer of their own brand that the infection rate is currently running at 50% and they are not happy. so Caveat Emptor (Buyer Beware)

21 10 2010
Funnyoldlife

50%?!? That’s shocking. It’s not just a case of explantation but all the risks of skin thinning in that area and it not healing up properly. Then you’ve *really* got problems. I wonder what those hospitals are doing, sacking the cleaners in order to cut costs maybe?

22 10 2010
sammarcko

Tina I would imagine with labour costs being what they are (low) it’s a lot more than laying off cleaners who work for a pittance in most developing countries anyway. Where I live you can have a full time maid and gardener for 300 odd quid a month. A cleaning woman earns 13.77 pounds per day and thats scrubbing, polishing, vaccuming, washing, ironing, and sometimes even cooking. Thats in a major metro area. Thats 7 hours work excluding lunch. In the sticks minimum wage is even less. Hell, India is even cheaper.
No. It’s definitely more than the lack of cleaners I would imagine. http://www.surgeryencyclopedia.com/Fi-La/Hospital-Acquired-Infections.html
Even the Indian Government by its own admission have no data in this article from the 16 Aug 2010
“The recent claim that NDM1 — the antibiotic-resistant superbug –has originated from India has left the Union health ministry fuming.
Both the Union health minister Ghulam Nabi Azad and his deputy Dinesh Trivedi are cross with the Lancet report, calling it “alarmist and having an ulterior motive of hitting India’s booming medical tourism”.
However, the ministry ought to be really worried about the country’s high rate of hospital acquired infections (HAI). ”
Source: http://crofsblogs.typepad.com/h5n1/2010/08/india-ministry-lacks-data-on-hospital-acquired-infections.html
Manufacturers of CI are concerned no wonder. 50% is too high. Iraq is running at a similar rate.

6 09 2011
Mohan Kameswaran

This is a frivolous and unsubstantiated allegation and as a cochlear implant surgeon working in one of the largest centers in India, I can categorically state that the infection rate in most centres that I know is no more than any of their counterparts anywhere in the world. Before making these wild statements, I would strongly urge the person to get his facts straight.
Prof. Mohan Kameswaran

6 09 2011
Admin

Thank you for clarifying! One of my friends, a surgeon, had his CIs implanted in India and he sang their praises. Certainly, CI surgery in India is world- standard.

6 09 2011
Dr N Vaid

I definitely second Dr Kameswaran on his statements. The infection rates are definitely at par with any developed country in the world and there are publications to prove this along with presentations made in various international conferences. Its important that any person should think before making allegations and assumptions based on hearsay.
Dr Neelam Vaid

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