The system HERA of the Ministry of Health is the exclusive computer manager for the regulated orthoprosthetic benefit of the Valencian Community. Since communication support products (communicators and SAAC) are not part of the orthoprosthetic portfolio of the National Health System, they do not have a billing code uploaded to this platform and doctors cannot prescribe them through it. [1, 2]. Eye tracking devices like Irisbond (Hiru) or Tobii are not “outside” the public system, but rather they are outside the HERA pharmacy catalog because they belong to a totally different administrative and financing circuit.
Public aid for a SAAC:
On the Valencian Community, since the SAAC are not included in the state Health catalog, the main way to obtain them is Department of Social Services, Equality and Housing through its specific calls for personal autonomy. [1, 2]
There are two official processing routes depending on the patient's profile:
1. Annual Call for Individualized Aid for Personal Development
It is the ordinary way of the Generalitat Valenciana to acquire support technologies and communicators. It is managed as a non-refundable subsidy for the purchase of material. [1, 2]
- What does it cover?: The block of «Technical aid and support products» includes specific devices to alleviate communication or motor deficiencies. [1, 2]
- Economic limits of aid: The maximum amounts are assigned according to the type of recognized main disability:
- Mandatory requirements:
- Have a recognized legal degree of disability.
- Be under 65 years old at the time of application.
- Income limit: The income of the family unit cannot exceed three times the IPREM.
- A medical/psycho-pedagogical report proving that the deficiency prevents you from communicating through normal means. [, 2, 3]
- Where it is processed: Through the official procedure of the Electronic Headquarters of the GVA (Personal Autonomy Aid) or in person at the Territorial Directorates of Social Services of Valencia, Alicante or Castellón
Why doesn't Eye-Tracking appear in HERA?:
High-tech eye tracking systems (such as Irisbond) are not encoded in the HERA database for three regulatory and economic reasons:
- Hospital Management by Direct Tender: As it is a technology with a high economic cost, the Ministry of Health processes them as centralized supplies managed directly by the reference hospitals (such as the Hospital La Fe or the Clínico), and not through the orthopedics or pharmacies of the HERA system.
- Requirement of a Multidisciplinary Team: An ocular reader requires a strict clinical assessment (ophthalmological, neurological and speech therapy) that the HERA software is not designed to automatically audit or validate.
- National SIRPO Channel: At the state level, gaze readers are regulated under a specific code of the SIRPO (System of Information and Registration of Orthoprosthetic Products) of the Ministry of Health. The autonomies acquire them under the modality of «purchase or renting of complete communication solutions«, being excluded from the common orthoprosthetic electronic prescription. The patient still receives the device for free, but the delivery order is signed within the Management Committee of the corresponding Clinical Hospital instead of being processed in an orthopedics with the health card.
The cost of eye tracking systems varies significantly depending on whether you purchase only the peripheral component or the integrated medical solution (which includes adapted tablet, specific communication software and high-resistance housings).
At a general level, Irisbond and Tobii Dynavox compete in a similar price range for the health and care sector (between €1,500 and €11,000), reflecting their technological complexity and the health certifications they possess. [1, 2, 3]
1. Comparison of Peripheral Devices (Reader Only)
This option includes only the bar eye-tracking which connects via USB or USB-C to the user's own computer or tablet. [1]
- Irisbond Hiru: It has an official price of €2,156 (VAT included). Its great competitive advantage is that it is natively cross-platform (compatible with Windows and iPadOS with official Apple certification). [1, 2, 3]
- Tobii Dynavox PCEye 5: It is located around the 2.365 €. It is Tobii's medical standard for computers. It works mainly under a Windows environment and stands out for its precision in people who wear glasses or progressive contact lenses. [1, 2, 3]
(Note: Tobii sells a video game reader called Tobii Eye Tracker 5 for about €300, but not suitable for assisted communication, since it lacks medical certification, consumes excessive processing resources and is not compatible with communication software such as Grid 3). [1, 2, 3]
2. Complete Solutions or “Ecosystems” (Hardware + Software + Supports)
When families or public hospitals purchase the complete package ready to use, costs increase due to software licenses (such as Grid 3 o TD Snap) and the protective structure. [1, 2]
- Irisbond (Oskol Comunica Range): Oscillates between €3,500 and €5,000. It includes the Hiru reader, a tablet (usually Microsoft Surface or iPad), the Oskol reinforced protective case and the adapted communication software. [1, 2]
- Tobii Dynavox (I-Series / TD Pilot Models): They oscillate between €7,000 and €11,000. They are “all-in-one” medical devices (like the TD Pilot for iPad or I-13/I-16 for Windows) very robust that already have the eye tracker physically integrated into the screen chassis. [1, 2]
Summary of Cost Differences
| Concept | Irisbond (Hiru) | Tobii Dynavox (PCEye / TD Pilot) |
|---|---|---|
| Just the reading bar | ~2.156 € | ~2.365 € |
| Complete solution (Tablet + Pack) | ~€3,500 – €5,000 | ~€7,000 – €11,000 |
| Licenses / Calibration | Included in the support | Sometimes requires extra license payments |
| Base Compatibility | Windows and iPadOS | Depends on the specific model |
In the Valencian Community, the supply of these systems through public hospitals is not a purchase of property for the patient, but rather a regulated use benefit model.
Modality and Monthly Cost
- Cost for the user: The cost per month is 0 €. The public system assumes the full amount of the service.
- Administrative model: The Ministry of Health uses a renting/lease contract or service award with the technology company (like Irisbond).
- Payment per device: Management pays a monthly fee for each active device assigned to a patient. This fee already includes hardware, software licenses, technical maintenance and replacement in case of failure.
Return and Commitment
- Mandatory return: The device must be returned after use. When the patient no longer needs it (due to death, change to another technology, or loss of clinical functionality), the hospital or company retires the equipment. This is reconditioned to be assigned to another user on the waiting list.
1. Cost per Patient (Estimation of Renting Service)
- Approximate monthly fee: The administration pays a fee of between €120 and €250 per month per active user.
- What this cost includes: This fee is not just the rental of the hardware (such as Irisbond Hiru or Tobii PCEye). It covers the entire ecosystem: the heavy-duty medical tablet, the communication software with pictograms or predictive text-to-speech (Grid 3, TD Snap), the articulated anchor arm, insurance against breakage and on-site or remote calibration or repair technical service.
2. Global Tender Budget
- Base budget and investment: The Ministry tenders these services in multi-year lots (usually 2 to 4 years in force). Contracts for key health departments typically have a base tender budget of about 388.440 €, reaching total estimated values of up to 854.568 € according to the extensions contemplated and the volume of active patients in the community. [1]
- Competitive award: After the bidding of the authorized companies (approved distributors of Irisbond and Tobii Dynavox in Spain), the final award amounts are closed with competitive discounts of between 5% and 10% (with actual award averages around 656.160 € to cover all the demand of the assigned lot). [1]
Why does the Administration prefer this model?
Far from purchasing individual devices at a commercial sale price (which would imply spending between €4,000 and €10,000 per patient at once without ensuring their maintenance), the renting model allows Valencian healthcare to: [1]
- Pay only for actual use: If a patient sadly dies or regains some mobility and stops using the device, the administration stops paying the fee for that equipment or reassigns it.
- Outsource maintenance: Any breakdown, screen breakage due to a fall or misconfiguration of the device software eye-tracking It is repaired at zero cost by the successful manufacturer, guaranteeing that the patient is never left incommunicado.