Wang, Han-I, Wright, Barry Debenham, Bursnall, Matthew, Cooper, Cindy, Kingsley, Ellen, Le Couteur, Ann, Teare, Dawn, Biggs, Katie, McKendrick, Kirsty, de la Cuesta, Gina Gomez et al (show 9 more authors)
(2022)
Cost-utility analysis of LEGO based therapy for school children and young people with autism spectrum disorder: results from a randomised controlled trial.
BMJ OPEN, 12 (1).
e056347-.
Abstract
<h4>Objectives</h4>To assess the cost-effectiveness of LEGO-based therapy compared with usual support.<h4>Design</h4>Cost-utility analysis alongside randomised control trial.<h4>Setting</h4>Mainstream primary and secondary schools in the UK.<h4>Participants</h4>248 children and young people (CYP) with autism spectrum disorder (ASD) aged 7-15 years.<h4>Intervention</h4>LEGO-based therapy is a group social skills intervention designed specifically for CYP with ASD. Through play, CYP learn to use the skills such as joint attention, sharing, communication and group problem-solving. CYP randomised to the intervention arm received 12 weekly sessions of LEGO-based therapy and usual support, while CYP allocated to control arm received usual support only.<h4>Main outcome measures</h4>Average costs based on National Health Service (NHS) and personal social services perspective and quality-adjusted life years (QALYs) measured by EQ-5D-Y over time horizon of 1 year were collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated, and non-parametric bootstrapping was conducted. The uncertainty around the ICER estimates was presented using cost-effectiveness acceptability curve (CEAC). A set of sensitivity analyses were conducted to assess the robustness of the primary findings.<h4>Results</h4>After adjustment and bootstrapping, on average, CYP in LEGO-based therapy group incurred less costs (incremental cost was -£251 (95% CI -£752 to £268)) and gained marginal improvement in QALYs (QALYs gained 0.009 (95% CI -0.008 to 0.028)). The CEAC shows that the probability of LEGO-based therapy being cost-effective was 94% at the willingness-to-pay threshold of £20 000 per QALY gained. Results of sensitivity analyses were consistent with the primary outcomes.<h4>Conclusion</h4>Compared with usual support, LEGO-based therapy produced marginal reduction in costs and improvement in QALYs. Results from both primary and sensitivity analyses suggested that LEGO-based therapy was likely to be cost-effective.<h4>Trial registration number</h4>ISRCTN64852382.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Problem Solving, Quality-Adjusted Life Years, Quality of Life, Adolescent, Child, Cost-Benefit Analysis, State Medicine, Autism Spectrum Disorder |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 15 Dec 2023 10:55 |
| Last Modified: | 15 Dec 2023 10:56 |
| DOI: | 10.1136/bmjopen-2021-056347 |
| Open Access URL: | http://10.0.4.112/bmjopen-2021-056347 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3177429 |
Dimensions
Dimensions
