Cost-effectiveness analysis of HABIT-ILE in preschool children with bilateral cerebral palsy: a multicenter randomized controlled trial
- Journal
- Annals of physical and rehabilitation medicine (Q1)
- Published
- 4 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Rodolphe Bailly, Pauline Fracasso, Sandra Bouvier, Rodrigo Araneda, Yannick Bleyenheuft, Sylvain Brochard, et al.
- PMID
- 42551100
- DOI
- 10.1016/j.rehab.2026.102159
Why clinicians should know about it
- Picked for Pediatrics and Child Health (top studies of the week, 9 August 2026): High-quality evidence in a top journal
- Picked for Orthopedics and Sports Medicine (top studies of the week, 9 August 2026).
- Picked for Rehabilitation (top studies of the week, 9 August 2026).
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). 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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.