ArticleFrontiers in public health2026
A cost-utility analysis of the transcutaneous Osia System® compared to the percutaneous bone-conduction hearing implant Baha® Connect for hearing loss in Spain.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the cost-effectiveness of the transcutaneous bone-conduction hearing implant Osia® System compared to the percutaneous bone-conduction hearing implant Baha® Connect System in a pooled population of adults eligible for bone-conduction hearing implants, from the perspective of the Spanish National Health System. Methods: A lifetime Markov model with 6-month cycles was simulated based on a previously published Swedish study, incorporating three primary health states: "with implant," "without implant," and "dead." Clinical inputs included probabilities of adverse events (e.g., complications, device failure), health utilities in Quality-Adjusted Life Years (QALYs), and direct healthcare costs. Costs and QALYs were discounted at a 3% annual rate. Deterministic and probabilistic sensitivity analysis were conducted to assess the uncertainty of the model parameters. Results: In the base-case analysis, the Osia® System incurred a total cost of €24,555 per patient and yielded 15.94144 QALYs, while the Baha® Connect System accounted for €20,968 and generated 15.17033 QALYs. The incremental cost-effectiveness ratio (ICER) of the Osia® System was €4,651/QALY gained, compared to the Baha® Connect System. The model was most sensitive to utility values for each device. At a willingness-to-pay threshold of €30,000/QALY, the probabilistic sensitivity analysis showed that the Osia® System had a 62% probability of being cost-effective. Conclusion: From the Spanish healthcare system perspective, the Osia® System is a cost-effective alternative to the Baha® Connect System for the overall adult patient population with hearing loss in Spain eligible for a bone-conduction hearing implant. These results support its inclusion in national coverage and reimbursement policies to improve clinical and patient-reported outcomes and to promote sustainable healthcare delivery. However, these findings should be interpreted cautiously due to the reliance on non-Spanish clinical inputs and the absence of subgroup-specific analyses.
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