OBJECTIVES: In the field of otorhinolaryngology, health economic evaluations are widely used to assess overall short- and long-term costs associated with implantable bone conduction devices (BCIs), as well as evaluating the clinical effectiveness of such systems. While longitudinal cohort analyses follow the same group of individuals over time, generating data representing large consecutive single-center patient cohorts, Micro-simulations are mostly applied following individuals through models when data is mainly generated from systematic reviews of peer-reviewed published literature, using best practices. The objective of this study was to investigate differences in outcomes either attributed to the longitudinal economic analysis cohort modeling approach or the Markov-model based microsimulation approach.

METHODS: A decision analytic Markov-model was developed and analyzed as a Micro-simulation to estimate incremental costs and quality-adjusted life years (QALYs) of an active transcutaneous bone conduction implant (atBCI) compared to percutaneous bone conduction implants (pBCIs), following a 10-year time horizon. Costs were estimated from the perspective of National Health Service (NHS) and derived mainly from national tariff payment schemes. Results of the Micro-simulation approach were than compared to the results of the longitudinal economic analysis.

RESULTS: Results of the Micro-simulation showed total mean cumulative costs per patient of £12,562.00 for the atBCI and £12,652.00 for the pBCIs, 5-years post-implantation. Compared to the results of the longitudinal cohort analysis, total mean cumulative cost per patient (atBCI £12,453.00 vs pBCIs £12,575.00) did not differ significantly (Δ £109.00 for atBCI and Δ £77.00 for pBCIs).

CONCLUSIONS: There was little evidence that results of the Micro-simulation approach did not differ from the results of a longitudinal cohort analysis, comparing bone conduction implants within an NHS setting, when using real-world-data from systematic reviews of peer-reviewed published literature on the one hand or consecutive single-center based data on the other hand.