Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: results from a randomised controlled trial. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Byford, Sarah; Cary, Maria; Barrett, Barbara; Aldred, Catherine; Charman, Tony; Howlin, Patricia; Hudry, Kristelle; Leadbitter, Kathy; Le Couteur, Ann; McConachie, Helen; Pickles, Andrew; Slonims, Vicky; Temple, Kathryn; Green, Jonathan
• Is Part Of: BMC psychiatry. Volume 15:Issue 1(2015)
• Page Start: 1
• Page End: 13
• Publication Date: 2015-12
• Subjects: Autism -- Economic evaluation -- Cost-effectiveness -- Pre-school -- Communication; Psychiatry -- Periodicals; 616.89005
• DOI: 10.1186/s12888-015-0700-x
• Languages: English
• ISSNs: 1471-244X

Abstract

Abstract Background Autism is associated with impairments that have life-time consequences for diagnosed individuals and a substantial impact on families. There is growing interest in early interventions for children with autism, yet despite the substantial economic burden, there is little evidence of the cost-effectiveness of such interventions with which to support resource allocation decisions. This study reports an economic evaluation of a parent-mediated, communication-focused therapy carried out within the Pre-School Autism Communication Trial (PACT). Methods 152 pre-school children with autism were randomly assigned to treatment as usual (TAU) or PACT + TAU. Primary outcome was severity of autism symptoms at 13-month follow-up. Economic data included health, education and social services, childcare, parental productivity losses and informal care. Results Clinically meaningful symptom improvement was evident for 53 % of PACT + TAU versus 41 % of TAU (odds ratio 1.91, p = 0.074). Service costs were significantly higher for PACT + TAU (mean difference £4, 489, p < 0.001), but the difference in societal costs was smaller and non-significant (mean difference £1, 385, p = 0.788) due to lower informal care rates for PACT + TAU. Conclusions Improvements in outcome generated by PACT come at a cost. Although this cost is lower when burden on parents is included, the cost and effectiveness results presented do not support the cost-effectiveness of PACT + TAU compared to TAU alone. Trial registration Current Controlled TrialsISRCTN58133827