Cost-analysis of universal newborn hearing screening in the Philippines

ABSTRACT

OBJECTIVE: The prevalence of congenital bilateral permanent profound hearing loss in the Philippines is 1.3 per 1000 live births. The prevalence increases to 22 per 1000 live births for unilateral mild to moderate hearing loss. This study was conducted to determine the cost of establishing a universal newborn hearing screening (UNHS) program. Local prevalence data and current costs of screening, diagnostics and intervention strategies for bilateral permanent hearing loss were utilized to estimate the costs of implementing the program. METHODS: Both short-term and long-term costs for hearing screening centers and for families caring for hearing-impaired children were determined using a societal perspective. Calculations included cost of hearing loss and the effectiveness of testing strategies. In this study the societal cost was considered although some of the costs pertained to costs borne by individual patients or their families since none of the screening, diagnostic and intervention strategies are paid for by insurance companies. An exception is the partial subsidy for cochlear implantation that is reimbursable with the Philippine Health Insurance Corporation. RESULTS: Using published data on the prevalence of hearing loss and experience from a pilot universal newborn hearing screening project at a national tertiary hospital (Philippine General Hospital), the long-term benefits and savings from UNHS on a national scale greatly outweigh the immediate costs of testing and intervention. CONCLUSION: The cost benefit of UNHS program at a national level outweighs the financial burden of hearing impaired individuals and their families.