Key Considerations in Health Economic Evaluations of High-Intensity Speech Intervention for Children With Cleft...

This paper aims to provide speech and language pathologists and researchers with practical, educational guidance on designing health economic evaluations (HEEs) to assess the cost-effectiveness of high-intensity speech intervention (HISI) for children with cleft palate with or without cleft lip (CP±L).

Key methodological considerations for designing HEEs of HISI for children with CP±L were identified by drawing on established frameworks. The foundational framework by Drummond et al. (2015) and the CHEERS reporting standards served as guiding structures for organizing and synthesizing principles relevant to conducting rigorous and transparent HEEs. Based on this conceptual synthesis, this paper provides practical recommendations to support researchers in implementing high-quality HEEs in the context of HISI for children with CP±L.

Despite growing interest in HISI, rigorous evidence on its cost-effectiveness is still lacking. Well-designed HEEs are needed to inform policymakers about the efficient allocation of healthcare resources. Clear evidence on cost-effectiveness is essential to ensure that implementation and reimbursement decisions are based on interventions that are both clinically effective and economically justified.

What is already known on this subject High-intensity speech intervention (HISI) is increasingly used in the management of speech sound errors in children with cleft palate with or without cleft lip (CP±L), with growing evidence supporting its clinical effectiveness. However, despite rising healthcare costs and pressure on effective service delivery, evidence on the cost-effectiveness of HISI remains limited. Health economic evaluations (HEEs) are well established in health research but are underutilised in speech and language therapy, and existing studies often show considerable methodological variability and limited transparency in reporting. What this study adds to existing knowledge This paper provides structured, practical guidance for designing rigorous HEEs of HISI for children with CP±L. Drawing on established frameworks and the CHEERS reporting standards, it synthesises key methodological considerations tailored to speech and language therapy research. The study clarifies how HEEs can be systematically integrated into intervention research in this field and offers concrete recommendations to improve methodological quality, transparency, and comparability of future economic evaluations of speech interventions for children with CP±L. What are the clinical implications of this study? By supporting the design of high-quality HEEs, this paper enables speech and language pathologists and researchers to generate evidence on the economic value of HISI. Such evidence can inform service planning and reimbursement decisions, supporting efficient allocation of resources in cleft care. Ultimately, improved economic evidence may facilitate wider, equitable implementation of effective interventions while ensuring sustainability of speech and language therapy services for children with CP±L.