Study estimated the budget impact of adding robotic exoskeleton over-ground training to existing locomotor training strategies in the rehabilitation of people with spinal cord injury (SCI). A budget impact analysis (BIA) was conducted using data provided by four SCI Model Systems rehabilitation hospitals. Hospitals provided estimates of therapy utilization and costs about people with SCI who participated in locomotor training in the calendar year 2017. Interventions were standard-of-care walking training including body weight-supported treadmill training, overground training, stationary robotic systems (i.e., treadmill-based robotic gait orthoses), and overground robotic exoskeleton training. The main outcome measures included device costs, training costs for personnel to use the device, human capital costs of locomotor training, device demand, and the number of training sessions per person with SCI. Results indicated that robotic exoskeletons for over-ground training decreased hospital costs associated with delivering locomotor training in the base case analysis. This analysis assumed no difference in intervention effectiveness across locomotor training strategies. Providing robotic exoskeleton overground training for 10 percent of locomotor training sessions over the course of the year results in decreased annual locomotor training costs between $1114 and $4784 per year. The base case shows small savings that are sensitive to parameters of the BIA model which were tested in one-way sensitivity analyses, scenarios analyses, and probability sensitivity analyses. The base case scenario was more sensitive to clinical utilization parameters (e.g., how often devices sit idle and the substitution of high cost training) than device-specific parameters (e.g., robotic exoskeleton device cost or device life).
Author(s):
Pinto, Daniel |Garnier, Mauricio |Barbas, Jason |Chang, Shuo-Hsiu |Charlifue, Susan |Field-Fote, Edelle |Furbish, Catherine |Tefertiller, Candy |Mummidisetty, Chaithanya K.|Taylor, Heather |Jayaraman, Arun |Heinemann, Allen W.|
