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National Guideline Centre (UK). Hearing loss in adults: assessment and management. London: National Institute for Health and Care Excellence (NICE); 2018 Jun. (NICE Guideline, No. 98.)
P.1. Urgent and routine referral
P.1.1. Urgent referral
None
P.1.2. Routine referral
None
P.2. MRI
None
P.3. Subgroups
None
P.4. Early versus delayed management of hearing loss
None
P.5. Communication difficulties and limitations in function
None
P.6. Management of earwax
P.6.1. Treatment
Table 107Unit costs of relevant equipment
| Equipment | Unit cost | Per patient | Cost per patient | Source |
|---|---|---|---|---|
| For irrigation | ||||
| Electric irrigator | £159 | PCNFT | ||
| Cleansing tablet | £0.10 | 1 | £0.10 | Clegg 2010110 |
| Disposable jet tip | £0.44 | 1 | £0.44 | Clegg 2010110 |
| Total consumables per patient | £0.54 | |||
| For microsuction | ||||
| Suction machine | £550–760 | BCUHB, PCNFT | ||
| Microscope | £7,000–13,500 | PCNFT | ||
| Loupe [alternative to a microscope] | £799–2,600 | BCUHB, PCNFT | ||
| Refill bag | £5.83 | 0.05 | £0.29 | BCUHB |
| Specula (5 mm or 6 mm) | £0.60 | 1 | £0.60 | BCUHB |
| Suction tube | £0.72 | 0.5 | £0.36 | BCUHB |
| Fenestrated Zoellner suction tube | £1.18 | 1 | £1.18 | BCUHB |
| Olive oil spray 10 ml | £3.56 | 0.05 | £0.18 | BCUHB |
| Kidney dish open moulded 700 ml | £0.03 | 1 | £0.03 | BCUHB |
| Total consumables per patient | £2.64 | |||
Sources: Clegg 2010,110 Betsi Cadwaladr University Health Board (supplied on request, 2017), Pennine Care NHS Foundation Trust (supplied on request, 2017)
Table 108Unit costs of earwax softeners
| Ear drops | Cost | Quantity | Source |
|---|---|---|---|
| Almond oil | £0.91 | 50 ml | BNF Nov 2017113 NHS Drug Tariff Nov 2017420 |
| Chlorobutanol | £2.05 | 11 ml | BNF Nov 2017113 |
| Docusate sodium | £1.95 | 10 ml | BNF Nov 2017113 NHS Drug Tariff Nov 2017420 |
| Olive oil | £0.92 | 15 ml | BNF Nov 2017113 |
| Sodium chloride [nasal drops] | £0.95 | 10 ml | BNF Nov 2017113 |
| Urea hydrogen peroxide | £2.89 | 8 ml | BNF Nov 2017113 NHS Drug Tariff Nov 2017420 |
P.7. Sudden sensorineural hearing loss
Table 110Unit costs for selected specimen regimens of steroids for management of SSNHL
| Method | Drug | Regimen | Total quantity | Cost | Form of drug used |
|---|---|---|---|---|---|
| Oral | Prednisolone | 60 mg for 3 days, tapering over 5 days | 330 mg | £3.20(a) | 30 mg tablets |
| Oral | Prednisolone | 60 mg for 7 days, tapering over 5–7 days | 610 mg | £6.11(a) | 30 mg tablets |
| Oral | Prednisolone | 60 mg for 14 days, followed by taper | 990 mg | £9.61(a) | 30 mg tablets |
| Intratympanic | Dexamethasone | 0.3–0.4 ml of 5 mg/ml once a day × 3 days | 5.25 mg | £3.60(a)(b) | 3.3 mg/1 ml, 1 ampoule |
| Intratympanic | Dexamethasone | 2 mg x 4 doses | 8 mg | £4.80(a)(b) | 3.3 mg/1 ml, 1 ampoule |
| Intratympanic | Dexamethasone | 0.5–0.7 ml of 12 mg/ml once a day x 3 days | 19.8 mg | £6.60(a)(b) | 6.6 mg/2 ml, 1 ampoule |
| Intratympanic | Methylprednisolone | 25 mg × 4 doses | 100 mg | £6.32(a) | 40 mg powder and solvent for injection |
| Intratympanic | Methylprednisolone | 40 mg × 4 doses | 160 mg | £6.32(a) | 40 mg powder and solvent for injection |
| Intratympanic | Methylprednisolone | 80 mg (1.5–2 ml of 40 mg/ml) × 4 doses | 320 mg | £12.64(a) | 40 mg powder and solvent for injection |
P.8. Information and support
None
P.9. Decision tools
None
P.10. Assistive listening devices
None
P.11. Hearing aids
P.11.1. Hearing aids versus no hearing aids
None
P.11.2. 1 hearing aid versus 2 hearing aids
None
P.12. Hearing aid microphones and noise reduction algorithms
P.12.1. Microphones
None
P.12.2. Noise reduction algorithms
None
P.13. Monitoring and follow-up
None
P.14. Interventions to support the use of hearing aids
Table 112Unit costs for appointments
| Appointment | Cost | Comment | Source |
|---|---|---|---|
| Audiology face-to-face follow-up, adult | £53 | Currency code AS08 | NHS Reference costs 2015/16140 |
- Urgent and routine referral
- MRI
- Subgroups
- Early versus delayed management of hearing loss
- Communication difficulties and limitations in function
- Management of earwax
- Sudden sensorineural hearing loss
- Information and support
- Decision tools
- Assistive listening devices
- Hearing aids
- Hearing aid microphones and noise reduction algorithms
- Monitoring and follow-up
- Interventions to support the use of hearing aids
- Unit costs - Hearing loss in adultsUnit costs - Hearing loss in adults
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- Taxonomy Links for BioSample (Select 4376520) (1)Taxonomy
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