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

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.

Cost-effectiveness of ethyl-eicosapentaenoic acid in the treatment of bipolar disorder.

BACKGROUND: This study develops an economic model to evaluate the cost-effectiveness of ethyl-eicosapentaenoic acid (ethyl-EPA) as an adjunct treatment of bipolar I disorder. METHODS: A 1-year Markov model is used incorporating three health states: euthymic, manic and depressive. The model was populated using outcomes from a clinical trial on clinical efficacy and other published literature. RESULTS: The incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) of ethyl-EPA in comparison with placebo was estimated to be -£2,782 in 2008/09 prices, the negative ICER indicating ethyl-EPA to be a more effective and less costly treatment option than placebo in terms of cost savings of other resource use. CONCLUSIONS: The sensitivity analysis indicated that the results were robust. Future research covering a longer time period using broader costs of the disease will be required to consolidate these findings.