MedRhythms, Inc., Portland, ME 04101, USA.
Value & Evidence, Eversana, Burlington, ON L7N 3H8, Canada.
J Comp Eff Res. 2024 Oct;13(10):e240010. doi: 10.57264/cer-2024-0010. Epub 2024 Sep 3.
Chronic stroke walking impairment is associated with high healthcare resource utilization (HCRU) costs. InTandem™ is a neurorehabilitation system that autonomously delivers a rhythmic auditory stimulation (RAS)-based intervention for the at-home rehabilitation of walking impairment in adults in the chronic phase of stroke recovery. This study was conducted to estimate the budget impact of InTandem in comparison with currently available intervention strategies for improvement of gait/ambulation in individuals with chronic stroke walking impairment. A budget impact analysis (BIA) for InTandem was conducted based on a 1-million-member US third-party payer perspective over a 1-year time horizon. Key inputs for the budget impact model were: costs for each intervention strategy (InTandem, physical therapy, self-directed walking and no treatment), HCRU costs for persons with chronic stroke and anticipated HCRU cost offsets due to improvements in gait/ambulatory status as measured by self-selected comfortable walking speed (based on functional ability). In addition to the reference case analysis, a sensitivity analysis was conducted. Based on the reference case, introduction of InTandem was projected to result in overall cost savings of $439,954 in one year. Reduction of HCRU costs (-$2,411,778) resulting from improved walking speeds with InTandem offset an increase in intervention costs (+$1,971,824). Demonstrations of cost savings associated with InTandem were robust and were consistently evident in nearly all scenarios evaluated in the sensitivity analysis (e.g., with increased/decreased patient shares, increased HCRU cost or increased InTandem rental duration). The InTandem system is demonstrated to improve walking and ambulation in adults in the chronic phase of stroke recovery after a five-week intervention period. The BIA predicts that introduction of InTandem will be associated with overall cost savings to the payer.
慢性中风步行障碍与高医疗资源利用（HCRU）成本相关。InTandem™ 是一种神经康复系统，可自主提供基于节奏听觉刺激（RAS）的干预措施，用于慢性中风恢复期成人的家庭步行障碍康复。本研究旨在估计与目前改善慢性中风步行障碍患者步态/步行的干预策略相比，InTandem 的预算影响。基于 100 万美国第三方支付者的视角，在 1 年的时间内对 InTandem 进行了预算影响分析（BIA）。预算影响模型的关键投入包括：每种干预策略的成本（InTandem、物理疗法、自我指导的步行和无治疗）、慢性中风患者的 HCRU 成本以及由于步态/步行状态改善而导致的 HCRU 成本抵消（基于功能能力用自我选择的舒适步行速度衡量）。除了参考案例分析外，还进行了敏感性分析。根据参考案例，引入 InTandem 预计在一年内将节省总成本 439,954 美元。由于使用 InTandem 提高了步行速度，从而降低了 HCRU 成本（-2,411,778 美元），抵消了干预成本的增加（+1,971,824 美元）。与 InTandem 相关的成本节约证明是稳健的，并且在敏感性分析中评估的几乎所有场景中都始终存在（例如，增加/减少患者份额、增加 HCRU 成本或增加 InTandem 租金期限）。InTandem 系统被证明可以改善慢性中风恢复期成人的步行和行走能力，干预期为五周。BIA 预测，引入 InTandem 将与支付者的总成本节省相关。
