Presentation (CTI)

OBJECTIVES: To quantify the lifetime societal return on investment (ROI) of three priority assistive technologies (ATs): wheelchairs, hearing aids, and eyeglasses in Bangladesh, providing evidence to support health technology assessment and AT scale-up in low- and middle-income country (LMIC) settings.
METHODS: A cost-benefit analysis was conducted adopting the ATscale (2020) framework. Lifetime present-value benefits were estimated across four domains: employment gains, educational attainment, caregiver time savings, and health improvements. Costs were assessed via present-worth analysis; benefits were modelled with a ramp-up factor to reflect gradual real-world uptake. Probabilistic sensitivity analysis using Monte Carlo simulation quantified parameter uncertainty and ROI robustness.
RESULTS: All three ATs generated strongly positive societal returns. Deterministic ROIs were 5.82 (wheelchairs), 4.16 (hearing aids), and 37.38 (eyeglasses), yielding an overall ROI of 8.85, representing $8.85 in societal benefit per $1 invested. Monte Carlo estimates were consistent: 6.26 (95% CI: 6.18-6.34), 4.50 (4.44-4.56), 40.13 (39.65-40.62), and 9.13 (9.02-9.23), respectively. Narrow confidence intervals and steep cumulative distribution functions confirmed low variability and result robustness across plausible parameter ranges.
CONCLUSIONS: AT provision in Bangladesh generates substantial, robust lifetime economic returns across employment, education, health, and caregiving domains. These findings provide HEOR evidence for HTA frameworks and policymakers across LMIC settings in the Asia Pacific. This implies that AT investment is a high-value, equity-enhancing strategy aligned with SDG targets on universal health coverage and inclusive economic growth.