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

Research output: Contribution to journalArticlepeer-review


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 languageEnglish
Pages (from-to)316
JournalBMC Psychiatry
Publication statusPublished - 21 Dec 2015


  • 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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