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; PACT Consortium

doi:10.1186/s12888-015-0700-x

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, PACT Consortium

Division of Neuroscience

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	316
Journal	BMC Psychiatry
Volume	15
DOIs	https://doi.org/10.1186/s12888-015-0700-x
Publication status	Published - 21 Dec 2015

Keywords

Autistic Disorder
Child, Preschool
Communication
Cost-Benefit Analysis
Early Medical Intervention
Female
Health Resources
Humans
Male
Parents
Psychotherapy
Schools
Social Welfare
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

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10.1186/s12888-015-0700-x

Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: results from a randomised controlled trial
Byford, S. (Contributor), Cary, M. (Contributor), Barrett, B. (Contributor), Aldred, C. R. (Contributor), Charman, T. (Contributor), Howlin, P. (Contributor), Hudry, K. (Contributor), Leadbitter, K. (Contributor), Couteur, A. L. (Contributor), McConachie, H. (Contributor), Pickles, A. (Contributor), Slonims, V. (Contributor), Temple, K. J. (Contributor) & Green, J. (Contributor), figshare , 21 Dec 2015
DOI: 10.6084/m9.figshare.c.3597632.v1, https://figshare.com/collections/Cost-effectiveness_analysis_of_a_communication-focused_therapy_for_pre-school_children_with_autism_results_from_a_randomised_controlled_trial/3597632/1
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Byford, S., Cary, M., Barrett, B., Aldred, C. R., Charman, T., Howlin, P., Hudry, K., Leadbitter, K., Le Couteur, A., McConachie, H., Pickles, A., Slonims, V., Temple, K. J., Green, J., & PACT Consortium (2015). Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: results from a randomised controlled trial. BMC Psychiatry, 15, 316. https://doi.org/10.1186/s12888-015-0700-x

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

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.",

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author = "Sarah Byford and Maria Cary and Barbara Barrett and Aldred, {Catherine R} and Tony Charman and Patricia Howlin and Kristelle Hudry and Kathy Leadbitter and {Le Couteur}, Ann and Helen McConachie and Andrew Pickles and Vicky Slonims and Temple, {Kathryn J} and Jonathan Green and {PACT Consortium}",

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Byford, S, Cary, M, Barrett, B, Aldred, CR, Charman, T, Howlin, P, Hudry, K, Leadbitter, K, Le Couteur, A, McConachie, H, Pickles, A, Slonims, V, Temple, KJ, Green, J & PACT Consortium 2015, 'Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: results from a randomised controlled trial', BMC Psychiatry, vol. 15, pp. 316. https://doi.org/10.1186/s12888-015-0700-x

TY - JOUR

T1 - Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism

T2 - results from a randomised controlled trial

AU - Byford, Sarah

AU - Cary, Maria

AU - Barrett, Barbara

AU - Aldred, Catherine R

AU - Charman, Tony

AU - Howlin, Patricia

AU - Hudry, Kristelle

AU - Leadbitter, Kathy

AU - Le Couteur, Ann

AU - McConachie, Helen

AU - Pickles, Andrew

AU - Slonims, Vicky

AU - Temple, Kathryn J

AU - Green, Jonathan

AU - PACT Consortium

PY - 2015/12/21

Y1 - 2015/12/21

N2 - 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.

AB - 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.

KW - Autistic Disorder

KW - Child, Preschool

KW - Communication

KW - Cost-Benefit Analysis

KW - Early Medical Intervention

KW - Female

KW - Health Resources

KW - Humans

KW - Male

KW - Parents

KW - Psychotherapy

KW - Schools

KW - Social Welfare

KW - Journal Article

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1186/s12888-015-0700-x

DO - 10.1186/s12888-015-0700-x

M3 - Article

C2 - 26691535

SN - 1471-244X

VL - 15

SP - 316

JO - BMC Psychiatry

JF - BMC Psychiatry

ER -

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

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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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