The Out-of-pocket Expenses of People With Tinnitus in Europe

Carlotta M Jarach¹, Kyriaki Karydou², Ilias Trochidis², Alberto Bernal-Robledano³, Piet A van den Brandt^{4

5}, Rilana Cima^{6

7

8}, Christopher R Cederroth^{9

10}, Jose Antonio Lopez-Escamez^{3

11

12}, Simone Ghislandi¹³, Deborah A Hall¹⁴, Dimitris Kikidis¹⁵, Berthold Langguth^{16

17}, Alessandra Lugo¹, Birgit Mazurek¹⁸, Anna Odone^{19

20}, Martin Schecklmann¹⁶, Stefan Schoisswohl^{16

21}, Jorge P Simoes²², Winfried Schlee^{16

23}, Silvano Gallus¹

Affiliations

¹ Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Medical Epidemiology.
² ViLabs.
³ Instituto de Investigación Biosanitaria ibs.GRANADA.
⁴ Maastricht University Medical Centre, CAPHRI- School for Public Health and Primary Care, Department of Epidemiology.
⁵ Maastricht University Medical Centre, GROW- School for Oncology and Developmental Biology, Department of Epidemiology.
⁶ Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven University.
⁷ Tinnitus Center of Expertise, Centre of Expertise in Rehabilitation and Audiology.
⁸ Experimental Health Psychology, Faculty of Psychology and Neurosciences, Maastricht University.
⁹ Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet.
¹⁰ Translational Hearing Research, Tübingen Hearing Research Center, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen.
¹¹ Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER.
¹² Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney.
¹³ Department of Social and Political Sciences, Bocconi University.
¹⁴ School of Social Sciences, Heriot-Watt University.
¹⁵ Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Medical School.
¹⁶ Department of Psychiatry and Psychotherapy, University of Regensburg.
¹⁷ Interdisciplinary Tinnitus Clinic, University of Regensburg.
¹⁸ Tinnitus Center, Charité Universitätsmedizin Berlin.
¹⁹ School of Medicine, University Vita-Salute San Raffaele.
²⁰ Department of Public Health, Experimental and Forensic Medicine, University of Pavia.
²¹ Department of Psychology, Universität der Bundeswehr München.
²² Department of Psychology, Health and Technology, University of Twente.
²³ Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences.

PMID: 38797674
PMCID: PMC11464849
DOI: 10.2188/jea.JE20230358

The Out-of-pocket Expenses of People With Tinnitus in Europe

Carlotta M Jarach et al. J Epidemiol. 2024.

. 2024 Nov 5;34(11):515-525.

doi: 10.2188/jea.JE20230358. Epub 2024 May 25.

Authors

Affiliations

¹ Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Medical Epidemiology.
² ViLabs.
³ Instituto de Investigación Biosanitaria ibs.GRANADA.
⁴ Maastricht University Medical Centre, CAPHRI- School for Public Health and Primary Care, Department of Epidemiology.
⁵ Maastricht University Medical Centre, GROW- School for Oncology and Developmental Biology, Department of Epidemiology.
⁶ Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven University.
⁷ Tinnitus Center of Expertise, Centre of Expertise in Rehabilitation and Audiology.
⁸ Experimental Health Psychology, Faculty of Psychology and Neurosciences, Maastricht University.
⁹ Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet.
¹⁰ Translational Hearing Research, Tübingen Hearing Research Center, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen.
¹¹ Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER.
¹² Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney.
¹³ Department of Social and Political Sciences, Bocconi University.
¹⁴ School of Social Sciences, Heriot-Watt University.
¹⁵ Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Medical School.
¹⁶ Department of Psychiatry and Psychotherapy, University of Regensburg.
¹⁷ Interdisciplinary Tinnitus Clinic, University of Regensburg.
¹⁸ Tinnitus Center, Charité Universitätsmedizin Berlin.
¹⁹ School of Medicine, University Vita-Salute San Raffaele.
²⁰ Department of Public Health, Experimental and Forensic Medicine, University of Pavia.
²¹ Department of Psychology, Universität der Bundeswehr München.
²² Department of Psychology, Health and Technology, University of Twente.
²³ Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences.

PMID: 38797674
PMCID: PMC11464849
DOI: 10.2188/jea.JE20230358

Abstract

Background: Despite the high frequency of tinnitus and its impact on wellbeing, little is known about its economic burden, and, to our knowledge, no data are available on out-of-pocket (OOP) expenses.

Methods: In 2022, a survey was conducted on OOP costs of tinnitus. We enrolled 679 participants with slight, moderate, and severe tinnitus in Italy, United Kingdom, Netherlands, Germany, and Spain. We estimated annual OOP expenses for tinnitus-related healthcare visits, treatments, medications, and alternative medicine practices. Prevalence of tinnitus in the general population, obtained from a representative survey we conducted in Europe in 2017-2018, was used to generalize costs for people with any tinnitus at the national level.

Results: OOP expenses were 368€ (95% confidence intervals [CI], 78€-690€), 728€ (95% CI, 316€-1,288€), and 1,492€ (95% CI, 760€-2,688€) for slight, moderate, and severe tinnitus, respectively, with annual expenditure of 565€ for people with any tinnitus: 209€ for healthcare visits; 93€ for treatments; 16€ for drugs; 64€ for hearing supporting systems; and 183€ for acupuncture, homeopathy, and osteopathy. Individuals with slight, moderate, and severe tinnitus expressed a willingness to invest 1.6, 4.3, and 7.0 times their monthly income, respectively, to achieve complete relief from tinnitus.

Conclusion: This study offers for the first time insights into the OOP expenses incurred by individuals with tinnitus. OOP expenses exhibited substantial variations based on severity status, accounting for more than 17 billion € in the countries considered. In terms of financial burden, these findings align tinnitus to the recognized leading disabilities, including back pain and migraine.

Keywords: economic burden; epidemiology; out of pocket costs; patients’ perspective; tinnitus.

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Conflict of interest statement

Conflicts of interest: CMJ, KK, IT, ABR, RC, CRC, JALE, DK, BL, AL, BM, MS, SS, JPS, WS and SGallus received funding within the UNITI project. The same authors obtained support for attending meetings and travel from the same UNITI project. RC was supported by KU Leuven. JALE also received support for attending meetings and travel from the University of Sydney. BL received grants from the German Research Foundation, the German Bundesministerium für Bildung und Forschung, the European Union, the Bavarian-Czech University Association, and the Bavarian State. BL also received consulting fees and/or payments from Schwabe, Neuromod, Sea Pharma, Rovi. BL received payment for expert testimony from Bavarian State. BL holds an unpaid leadership role at Tinnitus Research Initiative and German Society for Brain Stimulation in Psychiatry. BL has stock in Sea Pharma and received equipment from Neurocare, Daymed. BM received additional support for attending meetings and travel from Charité – Universitätsmedizin Berlin. JPS received grants from the University of Twente and the University of Regensburg. WS declared to be stakeholder of Lenox uG and serves as a consultant for Pansatori GmbH, and Pohl-Boskamp GmbH & Co. KG. WS is speaker for Schwabe Pharma AG, and Medical Tribune, and holds the patent US20120046713A1.

References

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The Out-of-pocket Expenses of People With Tinnitus in Europe

Affiliations

The Out-of-pocket Expenses of People With Tinnitus in Europe

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical