Economic Evaluations of Early Intensive Behavioral Interventions for Autism

Abstract

The goal of economic evaluation is to determine whether a new or updated intervention maximizes health benefits to children and families for every dollar spent compared to the standard of care. In this chapter the basic concepts and methods of economic evaluation are introduced, including cost item identification, measurement and valuation; description of modelling approaches, study perspective and time horizon; and definitions of cost effectiveness and cost utility analyses. This chapter also includes a review of studies that evaluated the cost-effectiveness of Early Intensive Behavioral intervention (EIBI) in autism spectrum disorder (ASD). While the economic evaluations of EIBI are scarce, existing studies show that EIBI can be costly, but may result in cost savings to a public payer due to a reduction in the use of services such as special education or adult assistance programs. None of the studies which reported both incremental costs and outcomes was conducted alongside an observational study or an RCT. Prospective research should be conducted to evaluate the long-term effectiveness of alternative EIBI programs with clearly defined comparator and control groups, collection of resource use across different service sectors, and with preference-based health-related quality of life assessment incorporated in the design.KeywordsEconomic evaluationEIBIEarly intensive behavioural interventionCost-effectiveness analysisFunding decision-making