Cost-effectiveness analysis of HABIT-ILE in preschool children with bilateral cerebral palsy: a multicenter randomized controlled trial - 25/09/26
, Pauline Fracasso b, c, #, Sandra Bouvier a, b, Rodrigo Araneda d, e, Yannick Bleyenheuft e, Sylvain Brochard a, b, Mickael Dinomais f, g, Josselin Demas f, g, h, $, Myriam Le Goff-Pronost b, cHighlights |
• | HABIT-ILE significantly improves gross motor function in children with bilateral cerebral palsy. |
• | Intensive therapy accelerates functional autonomy compared to usual care. |
• | An investment of €1232 yields a one-point gain on the gross motor function measure. |
• | The programme is cost-effective at a willingness-to-pay threshold of €2000 per point. |
• | Clinical benefits support integration into care pathways for children with cerebral palsy. |
Abstract |
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). ICER GMFM was €1232 for the community perspective, reflecting the global per-unit cost increase in GMFM-66. €949 of the ICER GMFM 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.
Le texte complet de cet article est disponible en PDF.Keywords : Intensive rehabilitation, Cerebral palsy, Cost-effectiveness, Policymakers, Care pathways
Abbreviations : ANCOVA, AU$, CEACs, COPM, CP, Eco-MOOV, EUR, GMFCS, GMFM-66, HABIT-ILE, HAS, ICER, ITT, MACS, MCID, QALYs, WTP
Plan
Vol 69 - N° 6
Article 102159- septembre 2026 Retour au numéro
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