Presentation (CTI)

OBJECTIVES: To evaluate the cost-effectiveness of the Enhancing Pragmatic Language for Young children with Social communication difficulties (E-PLAYS) programme plus care as usual (CAU) compared to CAU alone.
METHODS: A within-trial cost-utility analysis from the National Health Service and Personal Social Services (NHS/PSS) perspective was conducted alongside the E-PLAYS-2 cluster-randomised controlled trial. Children aged 5-7 years across 89 UK schools were randomised to E-PLAYS (n=210) or CAU (n=180). Quality-adjusted life years (QALYs) were measured using the Child Health Utility 9D (CHU9D) for the primary economic analysis and EQ-5D-Y-3L for sensitivity analysis at baseline, 20, and 40 weeks. Resource use data (NHS/PSS, education, and societal perspectives) were collected and valued in 2023 British Pounds (£). Missing data were addressed via multiple imputation. Incremental cost-effectiveness ratios (ICERs) were estimated over 40 weeks, with uncertainty evaluated using non-parametric bootstrapping. Sensitivity analyses were conducted to test base-case robustness under various scenarios.
RESULTS: The estimated E-PLAYS intervention cost was £437.71 per participant. For the base-case analysis (NHS/PSS perspective utilising the CHU9D), E-PLAYS increased mean total costs by an average of £482.34 per child (95% CI: £424.40 to £542.25), while mean QALYs were highly comparable between groups (incremental QALY: -0.008; 95% CI: -0.015 to -0.001). These findings were consistent across all sensitivity analyses, including the secondary EQ-5D-Y-3L utility measure, complete-case framework, and broader educational and societal perspectives, even when excluding software development costs, confirming the robustness of the base-case analysis.
CONCLUSIONS: The school-based E-PLAYS computerised programme was associated with a modest increase in cost and similar health-related quality of life over 40 weeks compared with CAU alone, indicating limited short-term differences in economic and health outcomes.