The cost-effectiveness of supported employment for adults with autism

The cost-effectiveness of supported employment for adults with autism in the United Kingdom

From Autism

Adults with autism have high rates of unemployment. A survey by the National Autistic Society (NAS) in the United Kingdom reported that only 15% of adults of working age with autism are in full-time paid employment. Moreover, the majority of jobs held by adults with autism are unskilled and poorly paid. The cost of supporting people with autism is considerable. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. A decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. There is evidence that supported employment also has a positive effect on employment rates in such adults.

Abstract

Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings.

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Article details
Ifigeneia Mavranezouli, Odette Megnin-Viggars, Nadir Cheema, Patricia Howlin, Simon Baron-Cohen, and Stephen Pilling
The cost-effectiveness of supported employment for adults with autism in the United Kingdom Autism November 2014 18: 975-984, first published on October 14, 2013 doi:10.1177/1362361313505720

 

 

     
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