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

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



Abstract 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
Date made available21 Dec 2015

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