Economic analysis of early intervention for autistic children: findings from four case studies in England, Ireland, Italy, and Spain

Michela Tinelli*, Aine Roddy, Martin Knapp, Celso Arango, Maria Andreina Mendez, James Cusack, Declan Murphy, Roberto Canitano, Bethany Oakley, Vinciane Quoidbach

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13 months did not support its cost-effectiveness. We modeled cost-effectiveness over 6 years and across four European countries. Methods Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6 years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study. Results PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13 months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6 years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment. Discussion PACT may be recommended as a cost-saving early intervention for families with an autistic child.

Original languageEnglish
Article numbere76
JournalEuropean Psychiatry
Issue number1
Publication statusPublished - 21 Sept 2023


  • autism
  • children
  • cost-effectiveness
  • early intervention
  • family impacts
  • public policy


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