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


  • 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).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.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.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.Current Controlled Trials ISRCTN58133827.


  • Macdonald, Wendy
  • 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

publication date

  • 2015