Cost Effectiveness Analysis of a Parent-Training Program for Children with Neurodevelopmental Disabilities

Abstract

Background: Parent-training (PT) programs have shown evidence of managing neurodevelopmental disability (NDD) symptoms in children, but their cost effectiveness in either group coached, or self-managed formats compared to standard care, is unclear.Objectives: To assess the resource use, costs, and health-related quality of life per child, and measure incremental costs and incremental effectiveness per quality-adjusted life year (QALY) gained in group coached and self-managed PT compared to standard care from public, family and societal payer perspectives. Methods: In a randomized controlled trial, caregivers were assigned to group coached, self-managed or control groups and were followed at baseline, 5- and 10-months post-randomization. Total costs per child were bootstrapped and total utilities per child were utilized to calculate QALYs per child. The incremental costs and QALYs were used to inform the CUA, where the ICER was the measure of efficiency. Uncertainty analyses were run on select cost and price variables. Results: The cost utility analysis from the public payer perspective showed that group coached was more costly and more effective than control with an incremental cost of $1,139.46 and incremental QALY of 0.04, leading to an ICER of $30,618.70 per QALY gained. Self-managed training was also more costly and effective compared to control with an incremental cost of $3,607.42 and incremental QALY of 0.05, leading to an ICER of $78,329.34 per QALY gained. Conclusion: These results show that parent-training is a valuable option for caregivers of children with NDDs, in either format of group coaching or self-managed learning.