Cox, Edward Miles, Walker, Simon Mark orcid.org/0000-0002-5750-3691, Blower, Sarah Louise orcid.org/0000-0002-9168-9995 et al. (3 more authors) (2022) The cost-effectiveness of a proportionate parenting programme for primary caregivers and their child:an economic evaluation using evidence from the E- SEE Trial. BMC Health Services Research. 814. ISSN 1472-6963
Abstract
Background: Behavioural and mental disorders have become a public health crisis; averting mental ill-health in early years can achieve significant longer-term health benefits and cost savings. This study assesses whether the Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE-Steps) - a proportionate universal delivery model comprising the Incredible Babies book (IY-B) and the Incredible Years Infant (IY-I) and Toddler (IY-T) parenting programmes is cost-effective compared to services as usual (SAU) for the primary caregiver, child and dyad. Methods: Using UK data for 339 primary caregivers from the E-SEE trial, we conducted a within-trial economic evaluation assessing the cost-effectiveness of E-SEE Steps. Health outcomes were expressed in quality-adjusted life-years (QALY) and costs in UK pounds sterling (2018-19). Missing data were populated via multiple imputation and costs and QALYs discounted at 3.5% per annum. Cost-effectiveness results were conducted for primary caregivers, children and dyad using econometric modelling to control for patient co-variables. Uncertainty was explored through scenario and sensitivity analyses. Results: The average cost of E-SEE Stepsjavascript:void(0); intervention was £458.50 per dyad. E-SEE Steps was associated with modest gains in primary caregiver HRQoL but minor decrements in child HRQoL compared to SAU. For primary caregivers, E-SEE Steps was more effective (0.034 QALYs) and more costly (£446) compared to SAU, with a corresponding incremental cost-effectiveness ratio (ICER) of £13,011 per QALY. In children, E-SEE Steps was strictly dominated with poorer outcomes (-0.005 QALYs) and greater costs (£178) relative to SAU. QALY gains in primary caregivers exceeded those QALY losses found in children, meaning E-SEE Steps was more effective (0.031 QALYs) and costly (£621) for the dyad (ICER: £20,062 per QALY). All scenario analyses found E-SEE Steps cost-effective for the dyad at a £30,000 per QALY threshold. Sensitivity analyses found significant cost reductions from expansions in programme delivery and attendance. Conclusions: E-SEE Steps achieved modest health gains in primary caregivers but small negative effects on children and was more costly than SAU. E-SEE Steps appears cost-effective for the dyad, but the results should be interpreted with caution given the potential detrimental impact on children.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 22 Jun 2022 09:00 |
Last Modified: | 16 Oct 2024 18:29 |
Published Version: | https://doi.org/10.1186/s12913-022-08220-x |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1186/s12913-022-08220-x |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:188206 |
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Filename: FINAL_E_SEE_Economic_Manuscript_BMC_HSR_post_review.docx
Description: FINAL E-SEE Economic Manuscript - BMC HSR post-review