OBJECTIVES: Sacral Neuromodulation (SNM) has proven to be an effective, safe and cost-effective therapy that should be available for refractory Overactive Bladder (OAB) and Fecal Incontinence (FI) patients. Canary Islands are divided into two provinces: Las Palmas and Santa Cruz de Tenerife. Refractory OAB and FI patients from Las Palmas are referred to other Spanish regions to receive SNM. This Budget Impact Analysis (BIA) approaches two possible referral programs from the perspective of Canary Islands Health Service (CHS): the treatment of these patients in Tenerife in a regional Center of Excellence or in Madrid as representative of the mainland. METHODS: A BIA was developed to analyze the different direct costs related to each of the options for a refractory population of 11 OAB and 4 FI patients during 1 year. The net economic impact caused by the treatment of patients from Las Palmas with SNM therapy was calculated based on two previous cost-effectiveness models and was assumed to be similar in both cases. Costs related to hospitalization, travelling, and living expenses for the patient and the caregiver were also considered, as these costs are reimbursed by the CHS to the patients and caregivers. RESULTS: The net economic impact for the CHS of treating 15 new patients from Las Palmas with SNM in Madrid would be €118,871 for the first year of the therapy, while treating these patients in Tenerife’s Center of Excellence would be related to a net impact of €50,780. The savings provided by a referral program inside the Region would amount to €68,091; driven by differences in hospitalization, travelling and living expenses. CONCLUSIONS: In Canary Islands, the designation of Regional Centers of Excellence for specialized and effective treatments, such as SNM, would lead to important savings for the CHS, driven by differences in hospitalization, travelling and living expenses due to referral programs.