<p><img src="/views_img.php?pp=Cost%20benefit%20Analyses%20of%20behavioral%20intervention&amp;incr=" > views</p>
<p><span style="font-family:Verdana;color:#ff0000;">Note: 5/16/10 - Note to update this in Summer 2010 to add new references.</span></p>
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<hr /><p><span style="font-family:Verdana;"><table style="background:transparent;border:none;margin:0;padding:0"><tr style="background:transparent;border:none;margin:0;padding"><td style="background:transparent;border:none;margin:0;padding"><div class="toc"><ol type="1"><li><a href="#Introduction">Introduction</a></li><li><a href="#Actuarialreports">Actuarial reports</a></li><li><a href="#ResearchpapersoncostbenefitanalysisofEIBIampABA">Research papers on cost-benefit analysis of EIBI &amp; ABA</a></li><li><a href="#Relatedpapersonhealthcareutilizationforchildrenwithautism">Related papers on health care utilization for children with autism</a></li></ol></li></div></td></tr></table><br clear="left" /></span></p>
<h1><a class="pbTOC" name="Introduction"></a><span style="color:#ff6600;font-family:Verdana;font-size:75%;"><span style="font-weight:bold;">Introduction</span></span></h1>
<p>&nbsp;</p>
<p><a href="http://tinyurl.com/ck76vx"><span style="font-family:Verdana;"><strong>Counterpoint&nbsp;and&nbsp;arguments&nbsp;that&nbsp;might&nbsp;be&nbsp;framed&nbsp;against&nbsp;specific&nbsp;cost-benefit&nbsp;analyses</strong></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">To avoid being taken by surprise and being able to formulate a defensive strategy.</span></p>
<p>&nbsp;</p>
<p><a href="http://www.mi.gov/documents/dleg/85641_BCBSM_11-27-07.pdf_222301_7.pdf"><span style="font-family:Verdana;"><em><strong>ABA not experimental or investigational</strong></em></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">STATE OF MICHIGAN DEPARTMENT OF LABOR &amp; ECONOMIC GROWTH OFFICE OF FINANCIAL AND INSURANCE SERVICES</span></p>
<p style="margin-left:40px;"><a href="http://www.mi.gov/documents/dleg/85641_BCBSM_11-27-07.pdf_222301_7.pdf"><span style="font-family:Verdana;">http://www.mi.gov/documents/dleg/85641_BCBSM_11-27-07.pdf_222301_7.pdf</span></a></p>
<p>&nbsp;</p>
<p><span style="color:#FF0000;font-family:Verdana;"><strong>Updated for 2009</strong> </span><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/Arguments_for_private_insurance_%20coverage.pdf"><span style="font-family:Verdana;"><strong><em>Arguments&nbsp;in&nbsp;Support&nbsp;of&nbsp;Private&nbsp;Insurance&nbsp;Coverage&nbsp;of&nbsp;Autism-Related&nbsp;Services</em></strong></span></a><span style="font-family:Verdana;"><strong><em>:</em></strong></span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><strong><em>Eight arguments in justification for autism reform legislation</em></strong>. 23 pages. February 2009.</span></p>
<p style="margin-left:40px;"><a href="http://www.autismspeaks.org"><span style="font-family:Verdana;">Autism&nbsp;Speaks</span></a><span style="font-family:Verdana;">/</span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a><span style="font-family:Verdana;">. 1990 K Street NW, Washington, DC 20006.</span></p>
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<p><a href="#"><span style="font-family:Verdana;">Top</span></a></p>
<hr /><h1><a class="pbTOC" name="Actuarialreports"></a><span style="color:#ff6600;font-family:Verdana;font-size:75%;">Actuarial reports</span></h1>
<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/HC4AutismPanelReport061808.pdf"><span style="font-family:Verdana;"><strong><em>Autism&nbsp;Spectrum&nbsp;Disorders&nbsp;Mandated&nbsp;Benefits&nbsp;Review&nbsp;Panel&nbsp;Report</em></strong></span></a><span style="font-family:Verdana;"><em>: Evidence Submitted Concerning Pennsylvania HB 1150</em>.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Durham, NC: Abt Associates, Inc., June 18, 2008.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Panel Members: Michael Ganz, Ph.D., Lisa Lavange, Ph.D., Donna Mauch, Ph.D., Joseph Morrissey, Ph.D., Chris Pashos, Ph.D., William Schlenger, Ph.D., Linmarie Sikich, M.D.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">NB Applicable to all states.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">From </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a>&nbsp;</p>
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<p style="margin-left:40px;"><span style="font-size:75%;font-family:Verdana;">"Report Summary Conclusion: “The evidence submitted to the Pennsylvania Health Care Cost Containment Commission is sufficient to evaluate the impact of the HB 1150 mandate. The analyses and research papers support a finding of marginal premium increase costs of approximately $1 PM/PM attributable to the ASD benefit. These cost increases are modest relative to: ongoing insurance cost increases; estimated cost offsets for families and the Commonwealth; and better results for children and youth with ASD. The clinical and cost effectiveness research studies provided indicate that improvements in clinical and role functioning and quality of life can be anticipated for those children and youth with ASD who use evidence based behavioral therapies, including Applied Behavioral Analysis.”</span></p>
<p>&nbsp;</p>
<p><a href="http://tinyurl.com/dzu9ck"><span style="font-family:Verdana;"><strong><span style="font-style:italic;">A<span style="display:none;">&nbsp;</span>ctuarial Cost Estimate: <span id="lw_1237734852_1" class="yshortcuts">Connecticut Senate Bill</span> 301</span><br style="font-style:italic;" /></strong></span></a></p>
<p><a href="http://tinyurl.com/dzu9ck"><span style="font-family:Verdana;"><strong><span style="font-style:italic;">An Act Concerning <span id="lw_1237734852_2" class="yshortcuts">Health Insurance Coverage</span> for <span id="lw_1237734852_3" class="yshortcuts" style="border-bottom:1px dashed #0066cc;background:transparent none repeat scroll 0% 0%;">Autism Spectrum Disorders</span></span></strong></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc lambright, FSA, MAAA</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Fr<span style="display:none;">&nbsp;</span>om </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/GA%20Cost%20Analysis%20of%20161%203%202%202009.pdf"><span style="font-family:Verdana;"><em><strong>Actuarial Cost Estimate: Georgia Senate Bill 161 An Act Relating to Insurance Coverage for Autism</strong></em></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc Lambright, FSA, MAAA, March 2, 2009</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Fr<span style="display:none;">&nbsp;</span>om </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/KS_Report_Senate_Bill_12_2_19_2009.pdf"><span style="font-family:Verdana;"><em><strong>Actuarial Cost Estimate: Kansas Senate Bill 12 An Act Relating to Insurance Coverage for Autism</strong></em></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc Lambright, FSA, MAAA, March 2, 2009</span></p>
<p style="margin-left:40px;"><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/Kansas_SEHP_Fiscal_Note_Addendum_3_18_2009.pdf"><span style="font-family:Verdana;"><em><strong>Addendum</strong></em></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Fr<span style="display:none;">&nbsp;</span>om </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/MO%20Cost%20Model%202%2023%202009.pdf"><span style="font-family:Verdana;"><strong><em>Actuarial Cost Estimate: Missouri Senate Bill 167 – An Act Relating to Coverage for the Diagnosis and Treatment of Autism Spectrum Disorders</em></strong></span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc lambright, FSA, MAAA.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Fr<span style="display:none;">&nbsp;</span>om </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/UT%20Cost%20Model%202%2019%202009.pdf"><span style="font-family:Verdana;"><em><strong>Actuarial&nbsp;Cost&nbsp;Estimate: Utah Senate Bill 43</strong></em></span></a><span style="font-family:Verdana;"> <em>- Coverage for the Diagnosis and Treatment of Autism Spectrum Disorder</em>.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc lambright, FSA, MAAA. January 30, 2009.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Fr<span style="display:none;">&nbsp;</span>om </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
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<p>&nbsp;</p>
<p><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/Virginia%20Cost%20Analysis.pdf"><span style="font-family:Verdana;"><em><strong>Actuarial&nbsp;Cost&nbsp;Estimate:&nbsp;Virginia&nbsp;House&nbsp;Bill&nbsp;1588&nbsp;</strong></em></span></a><span style="font-family:Verdana;"><em>- Coverage for the Diagnosis and Treatment of Autism Spectrum Disorder</em>.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc lambright, FSA, MAAA. January 30, 2009.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">From </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<p><strong><em><a href="http://www.autismvotes.org/atf/cf/%7B2A179B73-96E2-44C3-8816-1B1C0BE5334B%7D/WA%20Report%20Senate%20Bill%205203%202%2019%202009.pdf"><span style="font-family:Verdana;">Actuarial Cost Estimate: Washington Senate Bill 5203:</span></a></em></strong><span style="font-family:Verdana;"> <em>An Act Relating to Insurance Coverage for Autism Spectrum Disorders</em>.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Oliver Wyman Actuarial Consulting, Inc., Marc Lambright, FSA, MAAA, February 19, 2009</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">From </span><a href="http://www.autismvotes.org"><span style="font-family:Verdana;">Autism&nbsp;Votes</span></a></p>
<p>&nbsp;</p>
<hr /><h1><a class="pbTOC" name="ResearchpapersoncostbenefitanalysisofEIBIampABA"></a><span style="font-family:Verdana;font-size:75%;"><span style="color:#ff6600;">Research papers</span> <span style="color:#ff6600;">on cost-benefit analysis of EIBI &amp; ABA</span></span></h1>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Bouder, J. N., Spielman, S., &amp; Mandell, D. S. (2009). </span><span style="text-decoration:underline;"><a href="http://dx.doi.org/10.1007/s10803-009-0701-z"><span style="font-family:Verdana;">Brief report: Quantifying the impact of <span id="lw_1237736432_0" class="yshortcuts" style="border-bottom:1px dashed #0066cc;">autism</span> coverage on <span id="lw_1237736432_1" class="yshortcuts" style="border-bottom:1px dashed #0066cc;">insurance premiums</span></span></a></span><span style="font-family:Verdana;">. <em><span id="lw_1237736432_2" class="yshortcuts" style="border-bottom:1px dashed #0066cc;background:transparent none repeat scroll 0% 0%;">Journal of Autism and Developmental Disorders</span></em><span style="text-decoration:underline;">,</span> 1573-3432 (Online)</span></p>
<p><span style="font-family:Verdana;">DOI: 10.1007/s10803-009-0701-z&nbsp;</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><strong>Abstract</strong></span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;">"Many states are considering legislation requiring <span id="lw_1237736432_3" class="yshortcuts" style="border-bottom:medium none;background:transparent none repeat scroll 0% 0%;">private insurance companies</span> to pay for autism-related services. Arguments against mandates include that they will result in higher premiums. Using Pennsylvania legislation as an example, which proposed covering services up to $36,000 per year for individuals less than 21 years of age, this paper estimates potential premium increases. The estimate relies on autism treated prevalence, the number of individuals insured by affected plans, mean annual autism expenditures, administrative costs, medical loss ratio, and total insurer revenue. Current treated prevalence and expenditures suggests that premium increases would approximate 1%, with a lower bound of 0.19% and an upper bound of 2.31%. Policy makers can use these results to assess the cost-effectiveness of similar legislation. "&nbsp;</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Commented on at,</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Autism Research Blog: Translating Autism</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">"</span><a href="http://www.translatingautism.com/2009/02/autism-coverage-and-insurance-premiums.html"><span style="font-family:Verdana;"><strong>Autism coverage and insurance premiums</strong></span></a><span style="font-family:Verdana;">"</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">Friday, February 27, 2009</span></p>
<p style="margin-left:40px;"><a href="http://www.translatingautism.com/2009/02/autism-coverage-and-insurance-premiums.html" target="_blank"><span style="font-family:Verdana;">http://www.translat ingautism. com/2009/ 02/autism- coverage- and-insurance- premiums. html</span></a></p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Chasson, G. S., Harris, G. E., &amp; Neely, W. J. (2007). </span><a href="http://dx.doi.org/10.1007/s10826-006-9094-1"><span style="font-family:Verdana;">Cost comparison of early intensive behavioral Intervention and special education for children with autism</span></a><span style="font-family:Verdana;">. <em>Journal of Child and Family Studies, 16</em>(3), 401-413.</span></p>
<p><span style="font-family:Verdana;">DOI: 10.1007/s10826-006-9094-1</span></p>
<p>&nbsp;</p>
<p><a href="http://planetaimaginario.org/COSTE_BENEFICIO_RR505.pdf"><span style="font-family:Verdana;"><strong>The Costs and Benefits of Earlier Identification and Effective Intervention: Final Report</strong></span></a><span style="font-family:Verdana;">. Ivy Papps, Alan Dyson, Research Report No. 505, Department for Education and Skills. Tecis LTD, 2004.</span></p>
<p><a href="http://www.dfes.go.uk/research"><span style="font-family:Verdana;">http://www.dfes.go.uk/research</span></a></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Ganz ML. <em>The costs of autism</em>. In: Moldin SO, Rubenstein JLR, (Eds.) Understanding Autism: From Basic Neuroscience to Treatment. Boca Raton, Fla: Taylor and Francis Group; 2006.</span></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Ganz, M.L. (2007). </span><a href="http://archpedi.ama-assn.org/cgi/content/full/161/4/343"><span style="font-family:Verdana;"><strong>The&nbsp;lifetime&nbsp;distribution&nbsp;of&nbsp;the&nbsp;incremental&nbsp;societal&nbsp;costs&nbsp;of&nbsp;autism</strong></span></a></p>
<p><span style="font-family:Verdana;"><em>Archives of Pediatric and Adolescent Medicine, 161</em>, 343-349.</span></p>
<p style="margin-left:40px;"><a href="http://archpedi.ama-assn.org/cgi/reprint/161/4/343"><span style="font-family:Verdana;">pdf</span></a></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><strong>ABSTRACT</strong>:&nbsp;</span></p>
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<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Objective</strong>: To describe the age-specific and lifetime incremental societal costs of autism in the United States.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Design</strong>: Estimates of use and costs of direct medical and nonmedical care were obtained from a literature review and database analysis. A human capital approach was used to estimate lost productivity. These costs were projected across the life span, and discounted incremental age-specific costs were computed.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Setting</strong>: United States.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Participants</strong>: Hypothetical incident autism cohort born in 2000 and diagnosed in 2003.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Main Outcome Measures</strong>: Discounted per capita incremental societal costs.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Results</strong>: The lifetime per capita incremental societal cost of autism is $3.2 million. Lost productivity and adult care are the largest components of costs. The distribution of costs over the life span varies by cost category.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;"><strong>Conclusions</strong>: Although autism is typically thought of as a disorder of childhood, its costs can be felt well into adulthood. The substantial costs resulting from adult care and lost productivity of both individuals with autism and their parents have important implications for those aging members of the baby boom generation approaching retirement, including large financial burdens affecting not only those families but also potentially society in general. These results may imply that physicians and other care professionals should consider recommending that parents of children with autism seek financial counseling to help plan for the transition into adulthood.</span></p>
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<p><span style="font-family:Verdana;">Hildebrand DG. <em>Cost-benefit analysis of Lovaas treatment for autism and autism spectrum disorder (ASD).</em></span></p>
<p><span style="font-family:Verdana;">Vancouver, British Columbia: Columbia Pacific Consulting; 1999.</span></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Jarbrink, K., Fombonne, E., &amp; Knapp, M. (2003). </span><a href="http://eprints.lse.ac.uk/archive/00000324/01/autistic-spectrum-disorder_J-of-Autism_33-4.pdf"><span style="font-family:Verdana;"><strong>Measuring the Parental, Service and Cost Impacts of Children with Autistic Spectrum Disorder: A Pilot Study</strong></span></a><span style="font-family:Verdana;">. <em>Journal of Autism and Developmental Disorders, 33</em>(4), 395-402.</span></p>
<p><span style="font-family:Verdana;">DOI: 10.1023/A:1025058711465</span></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Jensen, V. K., &amp; Sinclair, L. V. (2002). </span><a href="http://journals.lww.com/iycjournal/pages/articleviewer.aspx?year=2002&amp;issue=04000&amp;article=00006&amp;type=abstract"><span style="font-family:Verdana;">Treatment of autism in young children: Behavioral intervention and applied behavior analysis</span></a><span style="font-family:Verdana;">. <em>Infants &amp; Young Children, 14</em>(4), 42-52.</span></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Jacobson, J. W., Mulick, J. A. (2000). </span><a href="http://www.featbc.org/downloads/researchpapers/ASD_cost_benefit_2000.pdf"><span style="font-family:Verdana;"><strong>System and cost research issues in treatments for people with autistic disorders</strong></span></a><span style="font-family:Verdana;">, <em>Journal of Autism and Developmental Disorders, 30</em>(6), 585-593.</span></p>
<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Jacobson J. W., Mulick J.A., &amp; Green G. (1998). </span><a href="http://australiancentreforautismservices.com.au/wordpress/wp-content/uploads/2008/11/cost-benefit-analysis-of-early-behavioral-intervention.pdf"><span style="font-family:Verdana;"><strong>Cost-benefit&nbsp;estimates&nbsp;for&nbsp;early&nbsp;intensive&nbsp;behavioral&nbsp;intervention&nbsp;for&nbsp;young&nbsp;children&nbsp;with&nbsp;autism</strong></span></a><span style="font-family:Verdana;">:</span></p>
<p><span style="font-family:Verdana;"><strong>General&nbsp;model&nbsp;and&nbsp;single&nbsp;state&nbsp;case</strong>.&nbsp; <em>Behavioral Interventions, 13</em>(4), 201-226.&nbsp;</span></p>
<p><span style="font-family:Verdana;">DOI:10.1002/(SICI)1099-078X(199811)13:4&lt;201::AID-BIN17&gt;3.0.CO;2-R</span></p>
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<p style="margin-left:40px;"><span style="font-family:Verdana;"><strong>ABSTRACT</strong></span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;">Clinical research and public policy reviews that have emerged in the past several years now make it possible to estimate the cost-benefits of early intervention for infants, toddlers, and preschoolers with autism or pervasive development disorder - not otherwise specified (PDD - NOS). Research indicates that with early, intensive intervention based on the principles of applied behavior analysis, substantial numbers of children with autism or PDD - NOS can attain intellectual, academic, communication, social, and daily living skills within the normal range. Representative costs from Pennsylvania, including costs for educational and adult developmental disability services, are applied in a cost-benefit model, assuming average participation in early intensive behavioral intervention (EIBI) for three years between the age of 2 years and school entry. The model applied assumes a range of EIBI effects, with some children ultimately participating in regular education without supports, some in special education, and some in intensive special education. At varying rates of effectiveness and in constant dollars, this model estimates that cost savings range from $187,000 to $203,000 per child for ages 3-22 years, and from $656,000 to $1,082,000 per child for ages 3-55 years. Differences in initial costs of $33,000 and $50,000 per year for EIBI have a modest impact on cost-benefit balance, but are greatly outweighed by estimated savings. The analysis indicates that significant cost-aversion or cost-avoidance may be possible with EIBI.</span></p>
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<p>&nbsp;</p>
<p><span style="font-family:Verdana;">Järbrink K, &amp; Knapp M. (2001). </span><a href="http://archpedi.ama-assn.org/cgi/ijlink?linkType=ABST&amp;journalCode=spaut&amp;resid=5/1/7"><span style="font-family:Verdana;"><strong>The&nbsp;economic&nbsp;impact&nbsp;of&nbsp;autism&nbsp;in&nbsp;Britain</strong></span></a><span style="font-family:Verdana;">. <em>Autism, 5</em>, 7-22.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><strong>ABSTRACT</strong>&nbsp;</span></p>
<div class="breakout">
<p style="margin-left:40px;"><span style="font-family:Verdana;font-size:75%;">Little is known about the economic impact of autism. This study estimated the economic consequences of autism in the United Kingdom, based on published evidence and on the reanalysis of data holdings at the Centre for the Economics of Mental Health (CEMH). With an assumed prevalence of 5 per 10,000 (1 per 2000) , the annual societal cost for the UK was estimated to exceed £1 billion. The lifetime cost for a person with autism exceeded £2.4 million. The main costs were for living support and day activities. Family costs account for only 2.3 percent of the total cost, but a lack of relevant information limited our ability to estimate these costs. Minor improvements in life outcome for people with autism could substantially reduce costs over the lifetime.</span></p>
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<p><span style="font-family:Verdana;">Maltby J. (2000).</span><a href="http://tinyurl.com/5cmla2"><span style="font-family:Verdana;"><strong>The&nbsp;costs&nbsp;of&nbsp;autism:&nbsp;more&nbsp;than&nbsp;meets&nbsp;the&nbsp;eye</strong></span></a><span style="font-family:Verdana;">. <em>Advocate, 33(6)</em>,12-16.</span></p>
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<p><span style="font-family:Verdana;">Motiwala, S. S., Gupta, S., &amp; Lilly, M. B. (2006). </span><a href="http://www.hcerc.utoronto.ca/PDF/autism_healthcarePolicy.pdf"><span style="font-family:Verdana;"><strong>The cost-effectiveness of expanding intensive behavioural intervention to all autistic children in Ontario</strong></span></a><span style="font-family:Verdana;"> [Canada]. <em>Healthcare Policy, 1</em>(2), 135-151.</span></p>
<p><a href="http://www.hcerc.utoronto.ca/PDF/autism_healthcarePolicy.pdf"><span style="font-family:Verdana;">http://www.hcerc.utoronto.ca/PDF/autism_healthcarePolicy.pdf</span></a></p>
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<hr /><h1><a class="pbTOC" name="Relatedpapersonhealthcareutilizationforchildrenwithautism"></a><span style="color:#ff6600;font-family:Verdana;font-size:75%;">Related papers on health care utilization for children with autism</span></h1>
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<p style="margin-left:40px;"><span style="font-family:Verdana;">Liptak, G.S., Stuart, T., &amp; Auinger, P. (2006). </span><a href="http://dx.doi.org/10.1007/s10803-006-0119-9"><span style="font-family:Verdana;">Health&nbsp;care&nbsp;utilization&nbsp;and&nbsp;expenditures&nbsp;for&nbsp;children&nbsp;with&nbsp;autism</span></a><span style="font-family:Verdana;">.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><em>Journal of Autism and Developmental Disorders, 36</em>, 871-879.</span></p>
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<p style="margin-left:40px;"><span style="font-family:Verdana;">Mandell, D.S., Cao, J., Ittenbach, R., &amp; Pinto-Martin, J. (2006). </span><a href="http://dx.doi.org/10.1007/s10803-006-0088-z"><span style="font-family:Verdana;">Medicaid&nbsp;expenditures&nbsp;for&nbsp;children&nbsp;with&nbsp;autistic&nbsp;spectrum&nbsp;disorders</span></a><span style="font-family:Verdana;">:1994 to 1999.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><em>Journal of Autism and Developmental Disorders, 36</em>(4), 475-485.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;">DOI: 0.1007/s10803-006-0088-z</span></p>
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<p style="margin-left:40px;"><span style="font-family:Verdana;">Mandell, D.S. (2007). </span><a href="http://dx.doi.org/10.1007/s10803-007-0481-2"><span style="font-family:Verdana;">Psychiatric&nbsp;hospitalization&nbsp;among&nbsp;children&nbsp;with&nbsp;autism&nbsp;spectrum&nbsp;disorders</span></a><span style="font-family:Verdana;">.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><em>Journal of Autism and Developmental Disorders</em>, Online paper</span></p>
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<p style="margin-left:40px;"><span style="font-family:Verdana;">Shimabukuro, T.T., Grosse, S.D., &amp; Rice, C. (2007). </span><a href="http://dx.doi.org/10.1007/s10803-007-0424-y"><span style="font-family:Verdana;">Medical&nbsp;expenditures&nbsp;for&nbsp;children&nbsp;with&nbsp;an&nbsp;autism&nbsp;spectrum&nbsp;disorder&nbsp;in&nbsp;a&nbsp;privately&nbsp;insured&nbsp;population</span></a><span style="font-family:Verdana;">.</span></p>
<p style="margin-left:40px;"><span style="font-family:Verdana;"><em>Journal of Autism and Developmental Disorders, 38</em>, 546-552.</span></p>
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