An economic evaluation of the healthcare cost of tinnitus management in the UK

Background: There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. How...

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Main Authors: Stockdale, David, McFerran, Don, Brazier, Peter, Pritchard, Clive, Kay, Tony, Dowrick, Christopher, Hoare, Derek J.
Format: Article
Published: BioMed Central 2017
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Online Access:https://eprints.nottingham.ac.uk/49656/
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author Stockdale, David
McFerran, Don
Brazier, Peter
Pritchard, Clive
Kay, Tony
Dowrick, Christopher
Hoare, Derek J.
author_facet Stockdale, David
McFerran, Don
Brazier, Peter
Pritchard, Clive
Kay, Tony
Dowrick, Christopher
Hoare, Derek J.
author_sort Stockdale, David
building Nottingham Research Data Repository
collection Online Access
description Background: There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Methods: Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. Results: The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. Conclusions: NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology.
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spelling nottingham-496562020-05-04T19:01:27Z https://eprints.nottingham.ac.uk/49656/ An economic evaluation of the healthcare cost of tinnitus management in the UK Stockdale, David McFerran, Don Brazier, Peter Pritchard, Clive Kay, Tony Dowrick, Christopher Hoare, Derek J. Background: There is no standard treatment pathway for tinnitus patients in the UK. Possible therapies include education and reassurance, cognitive behavioural therapies, modified tinnitus retraining therapy (education and sound enrichment), or amplification of external sound using hearing aids. However, the effectiveness of most therapies is somewhat controversial. As health services come under economic pressure to deploy resources more effectively there is an increasing need to demonstrate the value of tinnitus therapies, and how value may be continuously enhanced. The objective of this project was to map out existing clinical practice, estimate the NHS costs associated with the management approaches used, and obtain initial indicative estimates of cost-effectiveness. Methods: Current treatment pathways, costs and health outcomes were determined from the tinnitus literature, national statistics, a patient survey, and expert opinion. These were used to create an Excel-based economic model of therapy options for tinnitus patients. The probabilities associated with the likelihood of an individual patient receiving a particular combination of therapies was used to calculate the average cost of treatment per patient, average health outcome per patient measured in QALYs gained, and cost-effectiveness, measured by the average cost per QALY gained. Results: The average cost of tinnitus treatment per patient per year is GB£717, equating to an NHS healthcare bill of GB£750 million per year. Across all pathways, tinnitus therapy costs £10,600 per QALY gained. Results were relatively insensitive to restrictions on access to cognitive behaviour therapy, and a subsequent reliance on other therapies. Conclusions: NHS provisions for tinnitus are cost-effective against the National Institute for Health and Care Excellence cost-effective threshold. Most interventions help, but education alone offers very small QALY gains. The most cost-effective therapies in the model were delivered within audiology. BioMed Central 2017-08-22 Article PeerReviewed Stockdale, David, McFerran, Don, Brazier, Peter, Pritchard, Clive, Kay, Tony, Dowrick, Christopher and Hoare, Derek J. (2017) An economic evaluation of the healthcare cost of tinnitus management in the UK. BMC Health Services Research, 17 (577). ISSN 1472-6963 Tinnitus Hearing aids Cost effectiveness Ear nose and throat General practice Audiology Clinical psychology Cognitive behaviour therapy Hearing aids https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2527-2 doi:10.1186/s12913-017-2527-2 doi:10.1186/s12913-017-2527-2
spellingShingle Tinnitus
Hearing aids
Cost effectiveness
Ear nose and throat
General practice
Audiology
Clinical psychology
Cognitive behaviour therapy
Hearing aids
Stockdale, David
McFerran, Don
Brazier, Peter
Pritchard, Clive
Kay, Tony
Dowrick, Christopher
Hoare, Derek J.
An economic evaluation of the healthcare cost of tinnitus management in the UK
title An economic evaluation of the healthcare cost of tinnitus management in the UK
title_full An economic evaluation of the healthcare cost of tinnitus management in the UK
title_fullStr An economic evaluation of the healthcare cost of tinnitus management in the UK
title_full_unstemmed An economic evaluation of the healthcare cost of tinnitus management in the UK
title_short An economic evaluation of the healthcare cost of tinnitus management in the UK
title_sort economic evaluation of the healthcare cost of tinnitus management in the uk
topic Tinnitus
Hearing aids
Cost effectiveness
Ear nose and throat
General practice
Audiology
Clinical psychology
Cognitive behaviour therapy
Hearing aids
url https://eprints.nottingham.ac.uk/49656/
https://eprints.nottingham.ac.uk/49656/
https://eprints.nottingham.ac.uk/49656/