TY - JOUR
T1 - Economic analysis of early intervention for autistic children
T2 - findings from four case studies in England, Ireland, Italy, and Spain
AU - Tinelli, Michela
AU - Roddy, Aine
AU - Knapp, Martin
AU - Arango, Celso
AU - Mendez, Maria Andreina
AU - Cusack, James
AU - Murphy, Declan
AU - Canitano, Roberto
AU - Oakley, Bethany
AU - Quoidbach, Vinciane
N1 - Funding Information:
Funding to support the authors' contribution to this work was supported by the European Brain Council as part of the Value of Treatment Project. Additional funding sources for C.A. and B.O. are listed below. C.A. has received support from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (ISCIII), co-financed by the European Union, ERDF Funds from the European Commission, "A way of making Europe," financed by the European Union - NextGenerationEU (PMP21/00051), PI19/01024 CIBERSAM, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant Agreement No. 101034377), Project AIMS-2-TRIALS (Grant Agreement No. 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundación Familia Alonso, and Fundación Alicia Koplowitz. Any views expressed are those of the authors and not necessarily those of the funders. B.O. received funding from the Innovative Medicines Initiative 2 Joint Undertaking under Grant Agreement No. 777394 (for AIMS-2-TRIALS). This Joint Undertaking receives support from the European Union's Horizon 2020 research and innovation program and EFPIA and AUTISM SPEAKS, Autistica, and SFARI.
Publisher Copyright:
© The Author(s), 2023.
PY - 2023/9/21
Y1 - 2023/9/21
N2 - 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.
AB - 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.
KW - autism
KW - children
KW - cost-effectiveness
KW - early intervention
KW - family impacts
KW - public policy
UR - http://www.scopus.com/inward/record.url?scp=85172177705&partnerID=8YFLogxK
U2 - 10.1192/j.eurpsy.2023.2449
DO - 10.1192/j.eurpsy.2023.2449
M3 - Article
C2 - 37732502
AN - SCOPUS:85172177705
SN - 0924-9338
VL - 66
JO - European Psychiatry
JF - European Psychiatry
IS - 1
M1 - e76
ER -