title: The cost-effectiveness of an intensive treatment protocol for severe dyslexia in children.
abstract: Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued by proxies using a general quality-of-life instrument (EQ-5D). We considered medical cost and non-medical cost (e.g. remedial teaching). The model computed cost per successful treatment and cost per quality adjusted life year (QALY) in time. About 75% of the total costs was related to diagnostic tests to distinguish between children with severe dyslexia and children who have reading difficulties for other reasons. The costs per successful treatment of severe dyslexia were €36 366. Successful treatment showed a quality-of-life gain of about 11%. At primary school, the average cost per QALY for severe dyslexia amounted to €58 647. In the long term, the cost per QALY decreased to €26 386 at secondary school and €17 663 thereafter. The results of this study provide evidence that treatment of severe dyslexia is cost-effective when the investigated protocol is followed.
authors.affiliation: Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, The Netherlands. hakkaart@bmg.eur.nl
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
authors.forename: Wim G
authors.initials: WG
authors.lastname: Goettsch
authors.forename: Michel
authors.initials: M
authors.lastname: Ekkebus
authors.forename: Patty
authors.initials: P
authors.lastname: Gerretsen
authors.forename: Elly A
authors.initials: EA
authors.lastname: Stolk
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis / Q000379:methods*; D004410:Dyslexia / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011788:Quality of Life / Q000523:psychology; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity; D016896:Treatment Outcome