The Monetary Value of Early Cochlear Implantation

Adult woman receiving a cochlear implant
Article Summary
  • Dr. Ivette Cejas worked with Dr. Esteban Petruzzello to estimate the cost of delaying the implantation of cochlear implants for people with severe-to-profound hearing loss.
  • The researchers found that the costs are dramatically more expensive for people who are diagnosed with early hearing loss but don’t receive cochlear implants.
  • One of the issues that delays cochlear implantation is access to the technology for diverse populations.

A unique collaboration between hearing loss and clinical research experts on the University of Miami Miller School of Medicine campus and a business expert on the UM Coral Gables campus created a first-of-its-kind study looking at economic, personal and societal costs of severe-to-profound hearing loss for people with and without cochlear implants.  

The good news is early-life cochlear implantation can reduce these costs. But access to the technology remains challenging in multiple ways.

“Unfortunately, while we know this technology could have great benefits in terms of an individual’s overall quality of life, there still is a lot of variability in coverage by states and by insurance companies,” said Ivette Cejas, Ph.D., associate professor and director of family support services in the Department of Otolaryngology at the University of Miami Miller School of Medicine. “And there are issues related to early intervention and equal access, especially when we talk about diverse populations.”

“We see here in the clinic that when individuals come to us who don’t have access to the technology, they need more comprehensive care,” Dr. Cejas continued. “We need to provide them with educational support, vocational training and other therapies. It is way more intense than if we were able to capture a child early on and implant them before their first birthday.”

Dr. Ivette Cejas
Dr. Ivette Cejas collaborated with a colleague from the University of Miami business school to gauge the cost of delays in cochlear implantation.

People with severe or profound hearing loss who do not receive a cochlear implant prior to age 1 can experience multiple disadvantages, including delays in development, a need for special education and lost lifelong work productivity. And the economic costs to the individual and society can be staggering, according to the study published online May 14 in the journal Laryngoscope.

For example, the estimated societal cost every year associated with profound and severe hearing loss is $37 billion.

“I was a little surprised when we had the overall cost … that caught me a little bit off guard,” Dr. Cejas said.

Dr. Cejas joined forces with Esteban Petruzzello, Ph.D., associate professor of professional practice in the Miami Herbert Business School and the health economist on the project. Dr. Petruzzello looked into the many costs associated with severe-to-profound hearing loss, with a focus on those associated with labor productivity losses.

“I was very happy to do this,” Dr. Petruzzello said. “Many of the costs associated with hearing loss have an economic component.”

He considered three main factors: medical costs, special education costs and then “the largest factor by far, costs associated with productivity losses.” People with severe-to-profound hearing loss achieve lower levels of education, which often translates to earning less money over their lifetimes.

“That shows that if we don’t get them early, if they are unable to obtain the proper education or go for higher education, that affects how they’re able to contribute to society in terms of employment and more,” Dr. Cejas said.

“That’s why I think it’s crucial to look at all of the types of costs involved with this,” Dr. Petruzzello added.

For example, the estimated lifetime costs for a person born with severe-to-profound hearing loss is $489,274. If they do not receive an implant, the cost rises to $608,167, dramatically more than the $390,931 in costs if they receive an implant early.

Medical costs associated with getting a cochlear implant are more than offset by the higher earnings potential when hearing loss is improved, Dr. Petruzzello found.

Fulfilling Its Mission

The University of Miami Miller School of Medicine is a pioneer in supporting this kind of translational work, Dr. Cejas said.

“It really fits with the mission,” he said. “The University provides an environment where there is a lot of collaboration across disciplines.”

The study is unique because the researchers were able to directly connect each individual’s income to their hearing status. Previous investigators linked these factors through statistical matching of disparate databases. In addition, the researchers used nationally representative surveys so individuals were not selected based on their hearing status.

“The objective data about what cochlear implants can do to reduce lifetime or societal costs is one way for us to start conversations and lobby groups that can accelerate change for people with severe-to-profound hearing loss,” Dr. Cejas said.

The American Cochlear Implant Alliance, an organization that supports awareness of cochlear implantation and advocates for patients, funded the study.

Tags: cochlear implants, Dr. Ivette Cejas, otolaryngology