Bilateral vestibulopathy - insight in impact on quality of life and economic burden

Objective: To investigate the impact of bilateral vestibulopathy (BV) on quality of life, capabilities and costs. Furthermore, to estimate the potential headroom of a vestibulocochlear implant treatment trajectory, and comparing it to the anticipated costs. Methods: Patients meeting the Bárány Society diagnostic criteria for BV were included. Data on quality of life (EQ-5D-5L) and capabilities (ICECAP-A) were obtained, along with BV related health care costs, and patient and family costs (last year and total disease duration) through a survey and interview. Productivity loss was measured using PRODISQ and Friction Cost Method. The one year and lifetime headroom were calculated. Experts were interviewed about anticipated health care consumption for a future treatment trajectory. Results: Fifty patients participated. The mean utility EQ-5D-5L score was 0.680, and the ICECAP-A score was 0.839. Mean total costs in the last year were €5,388 and €30,708 for the total disease duration. The one-year headroom was €12,261; and €306,489 for lifetime. The future treatment trajectory costs were €32,605 for the first year (excluding the implant and processor). Conclusion: BV patients have significantly lower health related quality of life compared to the general population. Combined with their health care consumption and other costs, this provides sufficient headroom for a potentially cost-effective vestibulocochlear implant treatment trajectory.