# Chapter 3: Return on investing in assistive technology

Delivering these benefits will require an investment of approximately USD 700 billion. This reflects a sustained investment over the lifetime of people currently in need of assistive technology. While substantial, this investment is cost-effective and will earn a return of 9:1.

There are two major components of the cost of delivering AT to those in need—upfront investments in systems strengthening and user- incurred costs (both one-off and recurring). Foundational investments to strengthen systems for effective AT delivery include building sustainable supply chains, establishing and supporting healthy markets, enactment of supporting policies, and more. User-incurred costs include a one-off case- finding and diagnosis cost and recurring costs for product procurement, fitting and training, and maintenance for as long as the individual uses AT.

Ensuring lifetime access to appropriate AT for all people needing at least one of the four focus products in LMICs today would cost approximately USD 700 billion over 55 years. This figure is based on meeting the needs of nearly 1 billion people over their lifetimes. It also includes high-level estimates of the cost of strengthening systems for AT delivery across LMICs. However, a significant scale-up should create efficiencies and reduce unit costs, bringing substantial savings to the estimated overall investment needs.

While the investment required is substantial, realising the vastly greater economic benefits from increased AT access would lead to a return on investment of 9:1. In other words, for each dollar invested in AT, there is nine dollars in return to users, families and the national economy. 48 As this estimate does not account for the non-financial health and social benefits that AT delivers to users and their communities, the overall benefits of these investments are significantly higher.

The ROI shows that this is a ‘smart buy’ for donors and governments alike. A 9:1 ROI ratio puts investments in expanded access to AT on a par with other important and impactful global initiatives, such as WHO’s ‘Best Buys for NCD Prevention’ 49 and improved childhood education50.