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

Sarah Byford*, Maria Cary, Barbara Barrett, Catherine R. Aldred, Tony Charman, Patricia Howlin, Kristelle Hudry, Kathy Leadbitter, Ann Le Couteur, Helen McConachie, Andrew Pickles, Vicky Slonims, Kathryn J. Temple, Jonathan Green

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

37 Citations (Scopus)
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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

Original languageEnglish
Article number316
JournalBMC Psychiatry
Publication statusPublished - 21 Dec 2015


  • Autism
  • Communication
  • Cost-effectiveness
  • Economic evaluation
  • Pre-school


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