Cost-effectiveness of cognitive-behavioral therapy versus treatment as usual for anxiety disorders in children with autism spectrum disorder |
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| Institution: | 1. Research Institute of Child Development and Education, University of Amsterdam, The Netherlands;2. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, The Netherlands;1. Institute of Psychiatry, King׳s College London, London, UK;2. OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK;3. Karolinska Institutet, Stockholm, Sweden;4. MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King׳s College London, London, UK;1. Department of Pediatrics, University of South Florida, United States;2. Department of Health Policy and Management, University of South Florida, United States;3. Department of Psychiatry & Behavioral Neurosciences, University of South Florida, United States;4. Department of Psychology, University of South Florida, United States;5. Rogers Behavioral Health – Tampa Bay, United States;6. All Children''s Hospital – Johns Hopkins Medicine, United States;1. MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King''s College London, De Crespigny Park, PO Box 80, London SE5 8AF, UK;2. Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King''s College London, De Crespigny Park, PO Box 50, London SE5 8AF, UK;3. Florence Nightingale School of Nursing & Midwifery, King''s College London, 57 Waterloo Road, London SE1 8WA, UK;4. Department of Psychological Medicine, King''s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK;5. Sackler Centre for Translational Neurodevelopment, Institute of Psychiatry, King''s College London, De Crespigny Park, PO Box 50, London SE5 8AF, UK;1. Triborough Educational Psychology and Consultation Service, London, UK;2. Centre for Research in Autism and Education (CRAE), UCL Institute of Education, University College London, UK;3. Department of Psychology and Human Development, UCL Institute of Education, University College London, UK;4. School of Psychology, University of Western Australia, Perth, Australia;1. Academic Medical Center, Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;2. Academic Center for Child and Adolescent Psychiatry, de Bascule, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands;3. University of Amsterdam, Department of Child Development and Education, Weesperplein 4, 1018 XA Amsterdam, The Netherlands;4. University of Amsterdam, Department of Developmental Psychology, Weesperplein 4, 1018 XA Amsterdam, The Netherlands |
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| Abstract: | The study's aim was to evaluate the cost-effectiveness of CBT compared to treatment as usual (TAU). In total, 49 children aged 8–18 years with ASD and comorbid anxiety disorders, and their parents, participated; 24 were assigned to CBT and 25 were assigned to TAU. Outcome measures were the percentage of children free from their primary anxiety disorder and quality adjusted life years (QALYs). Costs were measured using a retrospective cost-questionnaire. Effects and costs were assessed at pre-, post-, and three months after treatment. Effects and costs were not statistically different between CBT and TAU, however the incremental cost-effectiveness ratio (ICER) demonstrated that CBT dominates TAU. Bootstrapped ICERs demonstrated that CBT has a high probability to be more effective than TAU, however, the probability that either CBT or TAU is more costly did not differ much. Secondary analyses demonstrated fairly robust results. CBT seems a cost-effective intervention compared to TAU, however, long-term follow-ups and comparisons between CBT and specific TAUs are necessary. Cost-effectiveness analyses may help inform policy makers to decide how to treat anxiety disorders in children with ASD. |
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| Keywords: | Anxiety CBT TAU Cost-effectiveness |
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