Retrospective cost-effectiveness analysis of treatments for aphasia: an approach using experimental data

Am J Speech Lang Pathol. 2014 May;23(2):186-95. doi: 10.1044/2013_AJSLP-13-0037.

Abstract

Purpose: Evidence supports the effectiveness of speech-language treatment for individuals with aphasia, yet less is known about the cost-effectiveness of such treatments. The purpose of this study was to examine the incremental cost and cost-effectiveness of aphasia treatment using previously published data.

Method: The authors completed a retrospective cost-effectiveness analysis using experimental data that they extracted from 19 previously published aphasia treatment studies. Average and incremental cost-effectiveness ratios were calculated based on participants' pre- and posttreatment proficiency scores.

Results: The average cost-effectiveness ratio for all sessions was $9.54 for each 1% increase in the outcome of interest. Measures of incremental cost-effectiveness indicated that aphasia treatments resulted in statistically significant improvements up to and including 17 treatment sessions. Increases in proficiency occurred at a cost of approximately $7.00 per 1% increase for the first 3 sessions to more than $20.00 in the 14th session; the ratio was either not statistically significant or dominated (more costly and less effective) in later sessions.

Conclusions: This cost-effectiveness analysis demonstrated that initial aphasia treatment sessions resulted in relatively larger and more cost-effective benefits than did later aphasia treatment sessions. The findings reported here are preliminary and have limitations. Prospective studies are needed to examine the cost-effectiveness of speech-language treatment for individuals with aphasia.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aphasia / economics*
  • Aphasia / therapy*
  • Cost-Benefit Analysis
  • Health Expenditures*
  • Humans
  • Middle Aged
  • Models, Econometric
  • Reimbursement Mechanisms / economics
  • Retrospective Studies
  • Speech-Language Pathology / economics*