Costs involved in using a cochlear implant in South Africa

Abstract

Cochlear implantation is an expensive but effective lifelong intervention for individuals with a severe-to-profound hearing loss. The primary aim of this study was to survey the short-and long-term costs of cochlear implantation. Individuals (N=154) using cochlear implants obtained from the University of Stellenbosch-Tygerberg Hospital Cochlear Implant Unit in Cape Town, South Africa were surveyed using a questionnaire and patient record review. The questionnaire used a combination of closed and open-ended questions to gather both quantitative and qualitative information. Costs were categorised as short-and long-term costs. All costs were converted to constant rands (June 2010) using the Consumer Price Index to allow for comparison in real terms over time. In the first 10 years of implantation the average estimated costs incurred by adults totalled R379 626, and by children R455 225. The initial purchase of the implant system was the most substantial cost, followed by upgrading of the processor. Travel and accommodation costs peaked in the first 2 years. On average the participants spent R2 550 per year on batteries and spares. Rehabilitation for children cost an average of R7 200. Insurance costs averaged R4 040 per year, and processor repairs R3 000 each. In addition to the upfront expense of obtaining the cochlear implant system, individuals using a cochlear implant in South Africa should be prepared for the long-term costs of maintenance, accessing the unit, support services and additional costs associated with use. Knowledge of these costs is important to ensure that individuals are successful users of their cochlear implants in the long term.

Economic Analysis of Children’s Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis

“…Altogether, 86 studies met inclusion criteria (Fig 1),[26–111] with articles summarized into 36 different procedure groups.…”

Profound childhood hearing loss in a South Africa cohort: Risk profile, diagnosis and age of intervention

“…Cochlear implants are not provided by the South African National Department of Health and caregivers of children requiring cochlear implantation need to have adequate finances or access to funding from a private medical aid to be able to acquire this technology [64]. In 2010 the total average costs for a child for the first five and ten years post implantation was determined to be 298 961 ZAR and 455 225 ZAR respectively [64], with the current USD/ZAR conversion rate being 1 USD to 11.21 ZAR.…”

“…In 2010 the total average costs for a child for the first five and ten years post implantation was determined to be 298 961 ZAR and 455 225 ZAR respectively [64], with the current USD/ZAR conversion rate being 1 USD to 11.21 ZAR. Since implant systems are manufactured outside of South Africa and imported for use, these costs may fluctuate as a result of exchange rate changes [64]. Also, as a result of the weakening ZAR against the USD the past few years, implantable devices have become more expensive.…”

Amplification and aural rehabilitation in resource-constrained environments

“…In addition, most, if not all, cochlear implant centres in South Africa are in urban settings, and travelling adds additional costs. 40 Poor uptake rates do not just depend on the cost of the available technology. Cultural diversity needs to be acknowledged in relation to health-seeking behaviour and hearing aid uptake.…”