Estimated net saving to society from cochlear implantation in infants: a preliminary analysis.

Objectives/hypothesis: Although it is clear that cochlear implants (CIs) are highly cost-effective in adults and children, the possible additional economic benefit of implantation at younger ages has to be fully established to verify whether the costs and outcomes of CIs differ between infants and older children.

Study Design: Retrospective cohort study.

Methods: Comprehensive data of CI costs were obtained in four groups of children (age 2-11, 12-23, 24-35, and 72-83 months) from parent questionnaires, national healthcare and educational systems, and retail prices for materials used. Outcomes are compared in terms of receptive language level (Peabody Picture Vocabulary Test-Revised [PPVT-R]), with follow-up to the chronological age of 10 years.

Results: Implantation in infants was associated with a lower total cost for the first 10 years of life. The net savings to society ranged from around 21,000€ in the two younger classes to more than 35,000€ when comparing infants against children in the oldest group. When implantation was delayed, family costs played an important role in the increase in expenses. Children in the 2- to 11-month group scored significantly better at the PPVT-R than those in the other age groups (P < .05, P < .01, and P < .001, respectively; Dunn's test) at 10 years of age. The cost per 1-year gain in vocabulary age at the PPVT-R showed a substantial difference between the youngest and oldest age groups (13,266€/year, 17,719€/year, 20,029€/year, and 28,042€/year, respectively).

Conclusions: CIs for patients under 1 year of age afford significantly improved performance and a net savings to society.