Annals of physical and rehabilitation medicine · 2026
Cost-effectiveness analysis of HABIT-ILE in preschool children with bilateral cerebral palsy: a multicenter randomized controlled trial.
СтатьяРандомизированное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Bailly Rodolphe, Fracasso Pauline, Bouvier Sandra, Araneda Rodrigo, Bleyenheuft Yannick, Brochard Sylvain, Dinomais Mickael, Demas Josselin, Le Goff-Pronost Myriam
Аннотация
BACKGROUND: HABIT-ILE improves motor ability in preschool children with cerebral palsy (CP); however, to support integration into standard care, cost-effectiveness must be determined.
OBJECTIVES: To evaluate the cost-effectiveness of early HABIT-ILE versus usual care in 1-4-year-olds with bilateral CP, using the incremental cost per Gross Motor Function Measure-66 (GMFM-66) point gain, compared to usual daily activities, including usual rehabilitation, from a collective perspective.
METHODS: A multicenter randomized controlled trial compared early HABIT-ILE (50 h over 10 days, partially volunteer-supported) with usual daily activities, including usual rehabilitation. Micro-costing quantified costs from the community, healthcare, and family perspectives. Effectiveness was measured using the GMFM-66 (T0 vs. T2: 90-day follow-up) and analyzed using ANCOVA. Incremental cost-effectiveness ratio (ICER) and willingness-to-pay (WTP) were estimated using bootstrapped sensitivity analysis.
RESULTS: Thirty-five children were included (mean [SD] age, 37.15 (9.70) months; 43% female; 47% Gross Motor Function Classification System level II). HABIT-ILE generated significantly higher costs than control treatments across all perspectives: i) Community: €5702 vs €1133 (P < 0.05); ii) Healthcare: €4144 vs €625 (P < 0.001); and iii) Family: €1557 vs €472 (P < 0.001). GMFM-66 scores improved significantly more from T0 to T2 in the HABIT-ILE group (+4.10 points for HABIT-ILE and +0.39 points for control, mean difference = 3.71 points, SE = 1.01; d = 1.29; P = 0.002). ICERGMFM was €1232 for the community perspective, reflecting the global per-unit cost increase in GMFM-66. €949 of the ICERGMFM was covered by the healthcare system, and €283 was incurred by families.
CONCLUSION: The HABIT-ILE program improved outcomes more than usual care for preschool children with bilateral CP, with an ICER of €1232 per GMFM-66 point, a ratio deemed cost-effective at a WTP of €2000-3000, in an economic research model with the participation of volunteers. These results support the integration of HABIT-ILE into standard care pathways for preschool children with bilateral CP.
OBJECTIVES: To evaluate the cost-effectiveness of early HABIT-ILE versus usual care in 1-4-year-olds with bilateral CP, using the incremental cost per Gross Motor Function Measure-66 (GMFM-66) point gain, compared to usual daily activities, including usual rehabilitation, from a collective perspective.
METHODS: A multicenter randomized controlled trial compared early HABIT-ILE (50 h over 10 days, partially volunteer-supported) with usual daily activities, including usual rehabilitation. Micro-costing quantified costs from the community, healthcare, and family perspectives. Effectiveness was measured using the GMFM-66 (T0 vs. T2: 90-day follow-up) and analyzed using ANCOVA. Incremental cost-effectiveness ratio (ICER) and willingness-to-pay (WTP) were estimated using bootstrapped sensitivity analysis.
RESULTS: Thirty-five children were included (mean [SD] age, 37.15 (9.70) months; 43% female; 47% Gross Motor Function Classification System level II). HABIT-ILE generated significantly higher costs than control treatments across all perspectives: i) Community: €5702 vs €1133 (P < 0.05); ii) Healthcare: €4144 vs €625 (P < 0.001); and iii) Family: €1557 vs €472 (P < 0.001). GMFM-66 scores improved significantly more from T0 to T2 in the HABIT-ILE group (+4.10 points for HABIT-ILE and +0.39 points for control, mean difference = 3.71 points, SE = 1.01; d = 1.29; P = 0.002). ICERGMFM was €1232 for the community perspective, reflecting the global per-unit cost increase in GMFM-66. €949 of the ICERGMFM was covered by the healthcare system, and €283 was incurred by families.
CONCLUSION: The HABIT-ILE program improved outcomes more than usual care for preschool children with bilateral CP, with an ICER of €1232 per GMFM-66 point, a ratio deemed cost-effective at a WTP of €2000-3000, in an economic research model with the participation of volunteers. These results support the integration of HABIT-ILE into standard care pathways for preschool children with bilateral CP.