Evaluating the clinical- and cost-effectiveness of upgrading cochlear implants within the Hearing Service Program

This study examines the benefits of upgrading sound processors for a large cohort of Australian adult users in a senior (65+ years) population. These cochlear implant users do not have access to public funding for replacement sound processors, in contrast to clients whose hearing loss can be solved by hearing aids. For these people, a break-down of their sound processors, many of which are 10+ years old, would mean a regression to a severe to profound hearing loss and a significant reduction in quality of life.
Existing sound processors will be replaced with the Cochlear Nucleus 7 processor. The study will then evaluate the clinical-effectiveness of the processor upgrades using standard and novel hearing outcome measures, including lifestyle benefits and cognition, across the first year following the upgrade. In a subset of patients, novel performance and behavioural methods developed by NAL to assess real-world hearing (e.g. realistic conversation, listening effort) will also be included. The study will also assess the cost-effectiveness of the upgrades with a health economic evaluation. Both the clinical- and cost-effectiveness data will provide the evidence-base to inform recommendations for potential policy options for future CI users.
The study has the potential to inform government policy as well as international guidelines (e.g. National Institute for Health and Care Excellence, 2018), and will also be of significant international interest. NAL will work with the Department of Health on public announcements regarding this project and include key stakeholders in any messaging.