Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: Results from a randomised controlled trial

TY - JOUR

T1 - Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism

T2 - Results from a randomised controlled trial

AU - Byford, Sarah

AU - Cary, Maria

AU - Barrett, Barbara

AU - Aldred, Catherine R.

AU - Charman, Tony

AU - Howlin, Patricia

AU - Hudry, Kristelle

AU - Leadbitter, Kathy

AU - Le Couteur, Ann

AU - McConachie, Helen

AU - Pickles, Andrew

AU - Slonims, Vicky

AU - Temple, Kathryn J.

AU - Green, Jonathan

PY - 2015/12/21

Y1 - 2015/12/21

N2 - 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 Trials ISRCTN58133827

AB - 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 Trials ISRCTN58133827

KW - Autism

KW - Communication

KW - Cost-effectiveness

KW - Economic evaluation

KW - Pre-school

UR - http://www.scopus.com/inward/record.url?scp=84951082209&partnerID=8YFLogxK

U2 - 10.1186/s12888-015-0700-x

DO - 10.1186/s12888-015-0700-x

M3 - Article

AN - SCOPUS:84951082209

SN - 1471-244X

VL - 15

JO - BMC Psychiatry

JF - BMC Psychiatry

M1 - 316

ER -