Is stacking intervention components cost-effective? An analysis of the Incredible Years program.

OBJECTIVE Research demonstrates that interventions targeting multiple settings within a child's life are more effective in treating or preventing conduct disorder. One such program is the Incredible Years Series, which comprises three treatment components, each focused on a different context and type of daily social interaction that a child encounters. This article explores the cost-effectiveness of stacking multiple intervention components versus delivering single intervention components. METHOD The data involved 459 children, ages 3 to 8, who participated in clinical trials of the Incredible Years Series. Children randomized to one of six treatment conditions received one or more of the three following program components: a child-based program, a parent training program, and a teacher-based program instructing teachers in classroom management and in the delivery of a classroom-based social skills curriculum. RESULTS Per-child treatment costs and child behavior outcomes (observer and teacher reported) were used to generate cost-effectiveness acceptability curves; results suggest that stacking intervention components is likely cost-effective, at least for willingness to pay above $3,000 per child treated. CONCLUSIONS Economic data may be used to compare competing intervention formats. In the case of this program, providing multiple intervention components was cost-effective.