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Insurers routinely avoid covering costly high-tech prostheses by labeling them “not medically necessary” or “experimental.” But what if we shift the question from How much does it cost? to How much does it return? That’s the approach of a new study in Nature Scientific Reports, and the findings are eye-opening. Using real-world data, the paper suggests that every $1 spent on an advanced prosthetic hand generates about $9 in socioeconomic benefits by promoting amputees’ health and financial independence.
The idea that front-end spending on high-tech prosthetics can yield long-term savings is nothing new. Medicare’s decision to expand coverage for MPK prosthetic legs is based on the same basic idea. Likewise, the So EveryBODY Can Move initiative has achieved stupendous legislative success by persuasively arguing that small investments in amputees’ health can produce enormous reductions in public health spending.
The Nature analysis is based on a method known as Social Return on Investment (SROI). This framework expands on traditional ROI accounting by including societal costs and benefits, which comprise both direct monetary values (such as public health spending and individual earning capacity) and indirect values (such as caregiver stress and community integration). Since its development at the beginning of this century, SROI has gained adherents among economists in government, philanthropy, and tech-oriented industries such as healthcare, energy, agriculture, and engineering.
Another unique feature of the Nature paper is that it’s based on hard data from a clinical trial involving individual amputees, rather than estimates derived from massive data sets. The study involved 11 upper-limb amputees who used standard myoelectric prosthetic devices. These 11 individuals were trained on the Hannes hand, an advanced robotic device developed in Italy via a public-private partnership. The participants then used the Hannes over a three-month period, while researchers measured the participants’ functional capabilities and gathered subjective data about the device’s psychosocial impact.
At the end of the trial period, the researchers tallied up the tangible and intangible benefits the Hannes provided to the participants. Their assessment included indicators such as employment potential, social participation, functional independence, and mental health. It also measured the benefits reaped indirectly by caregivers, health systems, public support programs, and others in the community. The bottom line is eye-popping: The 11 Hannes hands in this study generated an aggregate socioeconomic benefit of nearly half a million euros in year one, more than triple the aggregate cost of those units (€148,500). That’s an SROI of more than 300 percent. Good luck finding that type of return anywhere else.
And it gets better. Over a five-year period—which corresponds to the expected life span of a bionic hand—the 11 Hannes devices project to deliver about €1.3 million in socioeconomic benefits, which translates to an SROI of 874 percent. We’ll spare you the detailed number-crunching the explains how these figures are calculated; check out the paper online if you want to see all the math. Here’s the authors’ high-level explanation for how this advanced prosthesis generates so much value:
“Beyond individual benefits, Hannes has far-reaching implications for economic health. The reduction in caregiving needs alleviates not only the physical and emotional burden on caregivers but also the economic opportunity costs associated with unpaid care. This allows caregivers to re-enter the workforce or redirect their time to other pursuits, contributing to overall economic productivity. For patients, job reintegration highlights the potential of advanced prostheses to support labor market participation, reducing dependence on social welfare systems and fostering economic stability. …. By addressing both physical and psychosocial challenges, the prosthesis aligns with value-based healthcare models that prioritize outcomes over costs. Hannes not only delivers substantial benefits to patients but also generates indirect gains for caregivers, healthcare providers, and society as a whole.”
The major caveat is that this study only involves 11 people. With a larger sample size, the SROI figures might not be so impressive. But you can let a lot of air out of that 874 percent figure and still end up with a staggeringly good return. There’s also the chance that a larger study would yield even higher SROI figures.
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