Discussion
’ disability, disability, autism
To our knowledge, this is the first economic evaluation of a preemptive intervention for infants showing early behavioral signs of autism. This study drew on data from a high-quality RCTA conservative approach to modeling downstream costs was adopted, including only third-party payer costs of the national disability insurer for disability supports and modeled to the 13th birthday. The analysis did not incorporate broader psychosocial and economic impacts (eg, labor force participation among parentsThere has been considerable discussion within the neurodevelopmental science community about the potential efficacy of preemptive interventions that focus on antecedent neurodevelopmental trajectories,There may be potential for improved efficiencies in iBASIS-VIPP delivery, such as in a clinical setting or a combination of clinic, home-based, and telehealth delivery.An assumption of our model concerned stability of ASD diagnosis—specifically, that 87% of children with an ASD diagnosis at age 3 would carry that diagnosis into middle childhood. This assumption was considered well supported because it was based on 2 high-quality studies.The current study has a number of design strengths. The study drew on high-quality clinical research data from an RCT that had 2 years of participant follow-up and replicated findings of a previous RCT. Downstream cost consequences relied on well-characterized published national data from a single-payer disability insurance system, in which the scope of services and supports must relate directly to participants’ disability. As such, payments made under the NDIS provide a reasonably comprehensive estimate of the cost to the human services sector of supporting disability associated with ASD—an approach to the estimation of cost consequences that is not available in other health systems. Estimated benefits are considered conservative in excluding some government, societal, and family costs and impact on quality of life.