OBJECTIVES: Hospitals are faced with a growing demand to implement costly technological innovations. The economic impact is important for local decision makers, particularly with regard to innovations with little evidence of clinical and medico-economic benefits. It must therefore be evaluated as closely as possible to local real-life context.

METHODS: In the context of requests to acquire biomedical equipments involving costly expenditure, a local budget impact analysis (BIA) tool was created. We relied on the methodology proposed for BIA on the national budget, which are intended to inform public decision-making. After a review of all the expenditure items that could impact on the budget, the following were selected: acquisition cost, cost of consumables, machine depreciation/maintenance, information technology costs, staff costs, potential costs of construction work. Excel software was used to create the tool.

RESULTS: Local BIA was performed for an ex-vivo perfusion system for donor hearts. In this particular context, potential gains are linked to increase in activity. Base-case scenario was based on the following assumption. For the expenditures, hospital purchase prices were considered for equipment and consumables acquisition costs, and hospital wages for additional staff required according to professional status. For the gains, we used hypotheses put forward by clinicians and hospital managers, considering the prevalence of the local population treated, and local data on hospital stays. A threshold of additional transplants to be performed per year to compensate for the additional costs associated with the acquisition and use of the equipment could be calculated. The analysis could also be regularly updated using actual cost data or new assumptions that take account of changes in activity.

CONCLUSIONS: The economic impact for our hospital was quantified using a local BIA tool, provided as a supplement to the HB-HTA report.