One sentence appears in almost every commercial deck for virtual reality in healthcare, with different numbers attached: "saves X euros per patient". It is the sentence an informed buyer tests first — and it is almost always the first to fall.
It is worth understanding why, because the conclusion is not "there is no return". It is that the return has to be measured in your own house, and there is a correct way to do it.
The real state of the economic literature
Our public library holds 87 studies on virtual reality in healthcare settings. Of those, eight are about cost and return — and even those come from very specific contexts: paediatric imaging without sedation, post-operative pain, a mental health programme in the UK.
Eight out of eighty-seven is not an accident of our selection. It is the state of the field: clinical research on virtual reality is abundant, economic research is scarce. Anyone presenting a savings figure as settled is generalising from very little.
Why the numbers do not transfer
Even when an economic study is good, three things stop its number from being yours:
1. The population is not the same. A trial in paediatric imaging measures children who, without virtual reality, would be sedated. If in your service those children are not sedated, the saving the study calculates does not exist for you — not because the technology fails, but because the avoided cost was never there.
2. The comparator is not the same. "Saves against what?" decides the whole result. Against nothing is easy. Against the distraction a nurse already provides with conversation, a tablet or a parent in the room, it is a different conversation — and that is the honest comparison.
3. The payer is not the same. A study from the public payer's perspective counts different things from one taken from the hospital's, and both count different things from a private care home's. A saving that lands in a national budget may never land in yours.
What to do instead of believing the number
Measure. A three-month pilot answers better than any brochure, as long as you decide beforehand what you are going to count. Four metrics are enough:
- Sessions delivered per week — the only one that says whether the thing actually entered the routine. A solution nobody uses returns zero, whatever the literature says.
- Who took part who did not before. This is the most defensible value in a care home or any service with group activities: reaching the people who were left out.
- Real staff time per session. Timed, not estimated. It is the true cost and it is always higher than the first estimate.
- Refusals and interruptions. How many said no, how many took the headset off early. It says more about fit than any satisfaction survey.
None of these four is a clinical metric, and that is deliberate: a pilot answers implementation questions well — does the team use it? where does it jam? — and does not answer clinical efficacy at all, however much you are promised otherwise.
How to write this into a tender
If you are preparing a tender, the question that separates suppliers is this:
"List the studies supporting the saving you claim, with population, comparator and payer perspective."
Those who have them, show them. Those who do not answer with success stories and testimonials — a perfectly legitimate answer, as long as it is not presented as economic evidence.
We do not claim savings ourselves. What we state is what can be verified: what the equipment does, what gets recorded, how much staff time it consumes, and where an institution's arithmetic usually closes. The Class I registration covers the base product and is not, and never was, an efficacy argument.
RVer is a virtual reality system for clinical use designed for healthcare settings, whose base product is registered as a Class I Medical Device with Infarmed (CDM 94571546) and bears the CE mark under MDR 2017/745. The RVer Motion, RVer Neuro and RVer Exposure modules are in development and are not covered by that registration.
The eight cost studies are in the public library, alongside the other 79. On running the pilot, see how to run a pilot in a health service. On a care home's arithmetic, see what it returns in a care home.