OBJECTIVES: RTR is a regional telemedicine network allowing consultancy between local and university hospitals located in Toulouse. RTR offers tele-consultations and distance training for practitioners located in isolated zones of access. This communication between different centres allows a better decision-making regarding the necessity of transferring patients to university hospitals. This study is a further step to the telemedicine tariffs study. To evaluate the health insurance savings associated with RTR network. METHODS: A pool of neurosurgery patients for whom telemedicine consultation led to released or avoided transfer was identified. The rate of modified transfer decisions due to teleconsultations was derived from patients' files. IN all, 240 patients' files of neurosurgery were analysed but only 172 provided the information on initial needs of transfer. 58 out of those 172 files corresponded to avoided transfers. Hospitalisation associated costs were identified from DRGs' tariffs. Practitioners clarified the main diagnosis what allowed to identify the corresponding DRG's. Costs related to patients' medical transfers (such as the use of helicopters or ambulances) to university hospitals were also computed. In order to assess the global RTR's impact, results observed from exploitable files have been extrapolated to the whole population (240 patients). RESULTS: For the 172 informed files, hospitalization cost savings: EUR198,643; transportation cost savings: EUR172,533. In 2005, Telemedicine consultation led to a total savings of EUR371,177 for 172 patients, an average cost by transfer avoided of EUR6,399. For the 240 patients consultations, the total costs savings was estimated at more than EUR851,148. CONCLUSION: These encouraging results suggest that RTR /1related expenses can largely be compensated by direct and indirect medical costs savings. This study has been realiseed with other diagnosis: the results are convergent with the neurosurgical approach.