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Background  Autism is associated with impairments that have life-time consequences for diagnosed individuals and a substantial impact on families. There is growing interest in early interventions for children with autism, yet despite the substantial economic burden, there is little evidence of the cost-effectiveness of such interventions with which to support resource allocation decisions. This study reports an economic evaluation of a parent-mediated, communication-focused therapy carried out within the Pre-School Autism Communication Trial (PACT).    Methods  152 pre-school children with autism were randomly assigned to treatment as usual (TAU) or PACT + TAU. Primary outcome was severity of autism symptoms at 13-month follow-up. Economic data included health, education and social services, childcare, parental productivity losses and informal care.    Results  Clinically meaningful symptom improvement was evident for 53 % of PACT + TAU versus 41 % of TAU (odds ratio 1.91,  p  = 0.074). Service costs were significantly higher for PACT + TAU (mean difference £4,489,  p  < 0.001), but the difference in societal costs was smaller and non-significant (mean difference £1,385,  p  = 0.788) due to lower informal care rates for PACT + TAU.    Conclusions  Improvements in outcome generated by PACT come at a cost. Although this cost is lower when burden on parents is included, the cost and effectiveness results presented do not support the cost-effectiveness of PACT + TAU compared to TAU alone.    Trial registration  Current Controlled Trials  ISRCTN58133827Electronic supplementary material  The online version of this article (doi:10.1186/s12888-015-0700-x) contains supplementary material, which is available to authorized users.

Cost-effectiveness analysis of a communication-focused therapy for pre-school children with autism: results from a randomised controlled trial