Statement of purpose Motorcycle riders are one of the most vulnerable road users. Helmet use may reduce healthcare cost due protective effects against head injuries. In this study, we aimed to estimate the difference in the healthcare cost of head injuries among motorcycle riders who were wearing helmet and those who were not wearing helmet at the time of crash.

Methods/Approach Motorcycle crash victims that were brought to a public tertiary care emergency in Karachi between July to September 2019 were studied through descriptive cross-sectional design. A self- structured standard questionnaire form was used to collect data on demographics, injury pattern, helmeting practice, and length of hospital stay, out-of-pocket payments (OOP), healthcare service utilization at the facility and all direct and indirect medical costs incurred during hospitalization period.

Results 323 motorcyclists were involved in the accident, 112 patients had head injuries with mean age of 32 years old. The helmeted motorcyclists had a significantly lesser median total healthcare cost of PKR 10796 ($69) [IQR 9851 -12581] as compared to higher cost of PKR 12113 ($77) [10431 - 50545] by the non-helmeted counterpart during the hospital stay.

Conclusion The results of this study demonstrates that helmet use among motorcyclists can significantly reduce healthcare costs and healthcare resource utilizations during hospitalization in managing head injuries. Thus, it is important to implement strict helmeting practice to decrease cost burden on healthcare facilities and patient’s caregivers.

Significance The cost-saving ability of helmet use is widely reported around the globe. However, many studies have reported hospital charges instead of cost which may not reflect the actual cost of managing injuries. Our study has used healthcare cost estimation to provide contextual evidence on cost-saving ability of helmet and can help in prioritizing mandatory helmet use for injury prevention and reduction in economic burden on healthcare system.