Longitudinal economic analysis of Bonebridge 601 versus percutaneous bone anchored hearing devices over a 5-year follow-up period.

OBJECTIVES Percutaneous bone anchored hearing devices (pBAHDs) are the most commonly used bone conduction implants (BCI). Concerns surround the long-term complications, notably skin-related, in patients with percutaneous abutments. The active transcutaneous BCI Bonebridge system can help avoid some of these pitfalls but is often considered a second line option due to various factors including perceived increased overall costs. DESIGN Longitudinal economic analysis of Bonebridge BCI 601 versus pBAHD over a 5-year follow-up period. SETTING A specialist hearing implant centre. PARTICIPANTS Adult patients (≥16 years) with conductive hearing loss, mixed hearing loss or single-sided deafness, who received a Bonebridge or pBAHD implant between 1/7/2013-1/12/2018 with a minimum 12-month follow-up. MAIN OUTCOME MEASURES We compared the mean costs per implanted patient for both implants at 1, 3 and 5 years post-operative time points. Clinical effectiveness was evaluated using objective and patient-reported outcome measures. RESULTS The mean total cost per patient of Bonebridge was significantly higher than pBAHD at 1-year post-implantation (£8,512 standard deviation [SD] £715 vs £5,590 SD £1,394, p 0.05). The overall cost convergence was mainly accounted for by the increased long-term complications, revision surgery rates and higher cost of the pBAHD external processor compared to Bonebridge. CONCLUSIONS Long-term costs of Bonebridge to healthcare providers are comparable to pBAHDs, whilst offering lower complication rates, comparable audiological benefit and patient satisfaction. Bonebridge should be considered as a first line BCI option in appropriate cases.