Table A19:

Budget Impact Analysis of Adopting rTMS in Existing and Future (Looking-to-Start) rTMS Clinics in Ontario When Capital Cost is Excluded

Scenarios	Year 1 ($)	Year 2 ($)	Year 3 ($)	Year 4 ($)	Year 5 ($)	Total ($)
Current scenario	0	0	0	0	0	0
Costs specific to new scenarios
Long treatments (high-frequency rTMS)a	0.61	0.61	0.61	0.61	0.61	3.05
Brief treatments (iTBS) in existing rTMS clinics onlyb	8.14	9.66	12.21	12.21	14.24	56.46
Brief treatments (iTBS) in both existing and future (looking-to-start) rTMS clinics	8.14	12.21	14.75	15.26	17.30	67.66
Training costs	0.09	0.09	0.1	0.1	0.11	0.49
Total costs (new scenario) incurred from existing rTMS clinics onlyc	8.84	10.36	12.92	12.92	14.96	60.00
Total costs (new scenario) incurred from both existing and future (looking-to-start) rTMS clinicsc	8.84	12.91	15.46	15.97	18.02	71.20
Budget impact to fund existing rTMS clinics onlyd	8.84	10.36	12.92	12.92	14.96	60.00
Budget impact to fund both existing and future (looking-to-start) rTMS clinicsd	8.84	12.91	15.46	15.97	18.02	71.20

Abbreviations: iTBS, intermittent theta burst stimulation; rTMS, repetitive transcranial magnetic stimulation.

^aLong treatment is defined as a 37.5-minute session. An rTMS machine could run 8 sessions per day (communication with D. Blumberger, MD, on October 30, 2019). All costs expressed in 2019 Canadian dollars.

^bBrief treatment is defined as a 3-minute session. An rTMS machine could run 22 sessions per day (communication with D. Blumberger, MD, on October 30, 2019). All costs are expressed in 2019 Canadian dollars.

^cTotal costs = Long treatments (high-frequency rTMS) + Brief treatments (iTBS) + Training costs.

^dBudget impact = New scenario – Current scenario.