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Microsoft announces the Proteus Controller, a gamepad for Xbox gamers with disabilities
(www.theverge.com)
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It's a ton of money when comparing it to mainstream electronics, but I'd imagine that $300 single payment is a drop in the bucket for something medical. Anyone who needs it probably spends similar amounts or more adapting other everyday things for ease of use.
It's a niche probably low volume product that requires a good amount of hardware and software engineering.
Agreed, imagine what it would cost custom (though not necessarily DIY) or from a medical device manufacturer (shudder).