Can a costly intervention be cost-effective?: An analysis of violence prevention.

Foster, E. M., Jones, D. E., & Conduct Problems Prevention Research Group. (2006). Can a costly intervention be cost-effective?: An analysis of violence prevention. Archives of General Psychiatry, 63(11), 1284-1291.

DOI: https://doi.org/10.1001/archpsyc.63.11.1284 

Abstract: Foster, E. M., Jones, D. E., & Conduct Problems Prevention Research Group. (2006). Can a costly intervention be cost-effective?: An analysis of violence prevention. Archives of General Psychiatry, 63(11), 1284-1291. Objectives: To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design: Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the three outcomes measured in the 10th year of the study. Results: Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions: Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations.