BUDGET IMPACT OF POST-STROKE SPASTICITY MANAGEMENT USING ABOBOTULINUMTOXINA: HOSPITAL-AT-HOME VERSUS TRADITIONAL HOSPITAL CARE - A FRENCH PERSPECTIVE
Author(s)
Alexis SCHNITZLER, MD, PhD1, Yannick BLANCHETEAU, MD2, Eric FOSSIER, MD3, Guillaume DUVAL, MD4, José Fernandes Soares, MSc5, Laurence CARTON, MSc6, Sandra Boiziau, MSc6.
1Hôpital du Vésinet, Le Vésinet, France, 2Clinalliance, Villiers-sur-Orge, France, 3Breiz had Conseils, Larmor-Plage, France, 4Centre Hospitalier Universitaire, Angers, France, 5Rweality, Paris, France, 6Ipsen Pharma, Paris, France.
1Hôpital du Vésinet, Le Vésinet, France, 2Clinalliance, Villiers-sur-Orge, France, 3Breiz had Conseils, Larmor-Plage, France, 4Centre Hospitalier Universitaire, Angers, France, 5Rweality, Paris, France, 6Ipsen Pharma, Paris, France.
OBJECTIVES: Compare the budget impact of the abobotulinumtoxinA (aboBoNT-A) care pathway in Traditional Hospital Care (THC) versus Hospital-at-Home (HaH).
METHODS: A budget impact model was developed to estimate the economic implications of alternative care pathways for aboBoNT-A administration, stratified by patients’ living conditions (home vs care home) and care pathway (THC versus HaH). Two representative patient scenarios (patient 1, non-institutionalized and patient 2, institutionalized) were modelled over a two-year time horizon. Pathways (resources and care processes for toxin acquisition, administration, follow-up, and transport) were informed by a targeted literature review and expert consultation. The model included direct medical costs and patient transportation costs, in 2025 euros. Analyses were conducted from both the French Health Insurance (FHI) and healthcare providers’ perspectives, applying the relevant reimbursement and payment rules for each setting. Due to data uncertainty, the healthcare provider perspective is presented as a complementary analysis.
RESULTS: From the FHI perspective, HaH was less costly than THC across both patient profiles. Over a two-year period, mean savings per patient were €6,185.48 (patient 1) and €3,350.68 (patient 2). These savings were mainly driven by differences in the reimbursement of the toxin purchase cost by the FHI between the THC and HaH facilities (estimated at 50% of the toxin’s purchase cost), and by patient transport costs in the THC care pathway (€6,482.15 for patient 1 and €3,210.53 for patient 2). In a complementary provider-perspective analysis, HaH showed higher provider costs than THC due to liberal healthcare professionals' follow-up, though more favourable for institutionalised patients treated several per home visit.
CONCLUSIONS: This budget impact model suggests that, from the FHI perspective, the aboBoNT-A care pathway delivered via HaH is less costly than via THC. However, wider implementation of this pathway may require a reassessment of the HaH funding arrangements for this activity.
METHODS: A budget impact model was developed to estimate the economic implications of alternative care pathways for aboBoNT-A administration, stratified by patients’ living conditions (home vs care home) and care pathway (THC versus HaH). Two representative patient scenarios (patient 1, non-institutionalized and patient 2, institutionalized) were modelled over a two-year time horizon. Pathways (resources and care processes for toxin acquisition, administration, follow-up, and transport) were informed by a targeted literature review and expert consultation. The model included direct medical costs and patient transportation costs, in 2025 euros. Analyses were conducted from both the French Health Insurance (FHI) and healthcare providers’ perspectives, applying the relevant reimbursement and payment rules for each setting. Due to data uncertainty, the healthcare provider perspective is presented as a complementary analysis.
RESULTS: From the FHI perspective, HaH was less costly than THC across both patient profiles. Over a two-year period, mean savings per patient were €6,185.48 (patient 1) and €3,350.68 (patient 2). These savings were mainly driven by differences in the reimbursement of the toxin purchase cost by the FHI between the THC and HaH facilities (estimated at 50% of the toxin’s purchase cost), and by patient transport costs in the THC care pathway (€6,482.15 for patient 1 and €3,210.53 for patient 2). In a complementary provider-perspective analysis, HaH showed higher provider costs than THC due to liberal healthcare professionals' follow-up, though more favourable for institutionalised patients treated several per home visit.
CONCLUSIONS: This budget impact model suggests that, from the FHI perspective, the aboBoNT-A care pathway delivered via HaH is less costly than via THC. However, wider implementation of this pathway may require a reassessment of the HaH funding arrangements for this activity.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE63
Topic
Economic Evaluation, Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Budget Impact Analysis
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Geriatrics, Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas