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

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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

Original languageEnglish
Article number316
JournalBMC Psychiatry
Accepted/In press14 Dec 2015
Published21 Dec 2015


  • art_3A10.1186_2Fs12888_015_0700_x

    art_3A10.1186_2Fs12888_015_0700_x.pdf, 1.41 MB, application/pdf

    Uploaded date:01 Feb 2016

    Version:Final published version

    Licence:CC BY

King's Authors


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

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