Abstract
Introduction: NBD is a chronic condition in people with spinal cord injury, commonly manifesting as constipation and fecal incontinence. TAI is a minimally invasive alternative to conventional management. Peristeen Plus, a TAI device recommended, enables predictable bowel evacuation, reducing symptoms and quality of life, in line with NICE guidance. Its use is supported by structured training and remote follow-up from Clinical Specialists, promoting adherence and continuity of care, including across regions.Methods: Two BIAs were conducted from the perspective of the Italian NHS over a three-year time horizon. The first compared a current scenario with stable Peristeen Plus use to a revised scenario with increased adoption. The second assessed the economic impact of expanding home delivery distribution compared with traditional supply channels. Organizational impact and user experience were evaluated through online surveys involving patients, healthcare professionals, and Clinical Specialists.Results: The first BIA estimated € 1,435,224 in three-year savings from increased Peristeen Plus use, mainly due to fewer hospitalizations, UTIs, and specialist visits. The second BIA found € 58,391 in savings from expanded home delivery and reduced logistical burden for health authorities. Surveys reported high patient satisfaction with CS-led home training, improved self management, perceived continuity of care across regions, and organizational efficiencies with lower demand on clinical resources.Conclusions: The results of the model suggest that integrating Peristeen Plus with specialist support services may be associated with a favourable economic impact and potential organizational benefits within the Italian NHS. However, these findings are model-based estimates and should be confirmed through Italian real-world patient-level data.