Where are the autism economists?

Abstract

In the near future there are unlikely to be sufficient research funds to answer all the key questions associated with improving the lives of people with autism. Governmental and nongovernmental funders must make choices in distributing scarce research resources; these choices can be between disparate areas of health or involve deciding how to allocate funds between different approaches to a specific condition. This allocation of research funds to particular fields of study is influenced by many factors. Following up exciting new findings is a major driver, as novelty often evokes the prospect of a future “breakthrough,” with which funders would like to be associated. Technological developments and new theoretical frameworks offer a similar appeal, and it is not unusual for research domains to move in and out of fashion. Additionally, building incrementally on well replicated findings and maintaining the viability of established research groups and networks are important considerations. Usually, however, funding bodies do not have access to quantitative estimates of the value of a specific advance: this is the territory of micro- or health-economics. Most of us are familiar with the prognostications of macro-economists: individuals whose job is to understand and model the past behaviour of economies and industries and predict future trends. By contrast, micro-economists study choices relating to the use of scarce resources within a specific field of endeavour. In a very small number of countries we already know something about the costs of ASDs, and sometimes the potential value of improving services. But, to quantify gains from future research advances we need to be able to estimate both the probability that the desired outcome will be achieved and the value of this advance for affected individuals over specific time intervals, as well as for society more broadly. This is not an easy task, as many parameters will have broad confidence intervals and the delay before a discovery translates into an effective treatment or preventative strategy will vary significantly between different fields of research. Moreover, we are familiar with macro-economists providing conflicting advice because their models differ either in their inputs, their assumptions or both; which begs the question of whether the benefits of an economic analysis of autism research would be worth the effort? There are several complementary reasons for believing the answer to this question should be yes. First, even the crudest of analysis is likely to reveal some areas of research that are either under- or over-funded relative to the estimated value of their output. Of course these findings may match current assumptions, but it is likely that there will also be some surprises. Second, identifying under-funded research areas allows action to be taken immediately: money can be allocated to those areas and we can be sure that researchers will apply for it. Third, different economic models will probably lead to different answers, which will provide an incentive for debate and an improved understanding of the value of different types of scientific advance. Finally, an interest in value should help us all improve that most challenging of scientific endeavours: asking the right questions.