OBJECTIVES: Intrathecal baclofen (ITB) therapy is indicated for use in the management of intractable spasticity. Patients treated with ITB are required to receive a pump refill at least once every three months in the hospital (standard care (SC)). Since SC can be very burdensome for both patients and informal caregivers, an alternative approach (Care4homecare) has been developed which enables patients to receive pump refills at home. Moreover, the use of specially trained nurse practitioners ensures that there is no reduction in effectiveness. We compared the costs of both strategies. METHODS: Resource use in both strategies was estimated using observational data of 38 adult patients with spasticity (due to e.g. multiple sclerosis or spinal cord injury) that are currently living at home. We then combined this data with expert opinion and the Dutch costing manual to estimate the total one-year costs from a societal perspective. RESULTS: Patients included in the analysis had on average an age of 52±14.4 years, 50% was men and patients scored on average 44±12.5 points on the Care Dependency Scale. The Care4homecare strategy involves care that is almost identical to SC and therefore can result in comparable direct medical costs. However, patients receiving Care4homecare do not incur any travel costs compared with SC patients (€489). In addition, the productivity costs of informal caregivers (SC €195; Care4homecare €40) and of patients treated with Care4homecare are less than the costs of patients receiving SC. From a societal perspective, the total costs of Care4homecare can be lower than that of SC. CONCLUSIONS: Care4homecare is an alternative approach to treat patients with intrathecal baclofen that can be cost-neutral from a healthcare sector perspective and cost-saving from a societal perspective. Moreover, it can be a welcome option for many patients and caregivers who want to avoid the burden of regular hospital visits.