Skip to main content
Log in

Micro-Costing in Public Health Economics: Steps Towards a Standardized Framework, Using the Incredible Years Toddler Parenting Program as a Worked Example

  • Published:
Prevention Science Aims and scope Submit manuscript


Complex interventions, such as parenting programs, are rarely evaluated from a public sector, multi-agency perspective. An exception is the Incredible Years (IY) Basic Parenting Program; which has a growing clinical and cost-effectiveness evidence base for preventing or reducing children’s conduct problems. The aim of this paper was to provide a micro-costing framework for use by future researchers, by micro-costing the 12-session IY Toddler Parenting Program from a public sector, multi-agency perspective. This micro-costing was undertaken as part of a community-based randomized controlled trial of the program in disadvantaged Flying Start areas in Wales, U.K. Program delivery costs were collected by group leader cost diaries. Training and supervision costs were recorded. Sensitivity analysis assessed the effects of a London cost weighting and group size. Costs were reported in 2008/2009 pounds sterling. Direct program initial set-up costs were £3305.73; recurrent delivery costs for the program based on eight parents attending a group were £752.63 per child, falling to £633.61 based on 10 parents. Under research contexts (with weekly supervision) delivery costs were £1509.28 per child based on eight parents, falling to £1238.94 per child based on 10 parents. When applying a London weighting, overall program costs increased in all contexts. Costs at a micro-level must be accurately calculated to conduct meaningful cost-effectiveness/cost-benefit analysis. A standardized framework for assessing costs is needed; this paper outlines a suggested framework. In prevention science it is important for decision makers to be aware of intervention costs in order to allocate scarce resources effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  • Allen, G. (2011). Early intervention: The next steps. Retrieved from

  • Charles, J. M., Bywater, T., & Edwards, R. T. (2011). Parenting interventions: A systematic review of the economic evidence. Child: Care, Health and Development, 37, 462–474. doi:10.1111/j.1365-2214.2011.01217.x.

    Article  CAS  Google Scholar 

  • Curtis, L. (2008). Unit Costs of Health and Social Care. Retrieved from

  • Curtis, L. (2009). Unit Costs of Health and Social Care. Retrieved from

  • Dretzke, J., Frew, E., Davenport, C., Barlow, J., Stewart-Brown, S., Sandercock, J.,…Taylor, R. (2005). The effectiveness and cost-effectiveness of parent training/education programmes for the treatment of conduct disorder, including oppositional defiant disorder in children. Health Technology Assessment, 9, 1–250. doi:10.3310/hta9500.

    Google Scholar 

  • Drummond, M. F., Sculpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). Oxford: Oxford University Press.

    Google Scholar 

  • Edwards, R. T., Edwards, R. T., Ó Céilleachair, A. J., Bywater, T., & Hutchings, J. (2007). A parenting programme for children at risk of developing conduct disorder: A cost-effectiveness analysis. British Medical Journal, 10, 334–682. doi:10.1136/bmj.39126.699421.55.

    Google Scholar 

  • Furlong, M., McGilloway, S., Bywater, T., Hutchings, J., Donnelly, M., Smith, S.M., O’Neill, C. (2012). Behavioural/cognitive-behavioural group-based parenting interventions for children age 3–12 with early onset conduct problems. Cochrane Database of Systematic Review.

  • Griffith, G. L., Edwards, R. T., & Gray, J. (2004). Cancer genetic services: A systematic review of the economic evidence and issues. British Journal of Cancer, 90, 1697–1703. doi:10.1038/sj.bjc.6601792.

    Article  PubMed  CAS  Google Scholar 

  • Hutchings, J., Bywater, T., Daley, D., Gardener, F., Whitaker, C., Jones, K.,…Edwards, R.T. (2007). Parenting intervention in Sure Start services for children at risk of developing conduct disorder: Pragmatic randomised control trial. British Medical Journal, 334, 678681. doi:10.1136/bmj.39126.620799.55.

    Google Scholar 

  • International Monetary Fund (IMF). (2009). Currency convergence exchange rates. Retrieved from

  • Kinsella, S. (2004). Ten lessons for micro-costing in health economics. Retrieved from

  • McGilloway, S., Ni Mhaille, G., Bywater, T., Comiskey, C., Donnelly, M., Leckey, Y., & Kelly, P. (2012). A parenting intervention for tackling childhood behavioral problems: A randomized controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology, 80, 116–127. doi:10.1037/a0026304.

  • Medical Research Council. (2008). Guidance on the development, evaluation and implementation of complex interventions to improve health. Retrieved from http://

  • Morris, S., Devlin, N., & Parkin, D. (2007). Economic analysis in health care. Chichester, UK: Wiley and Sons.

  • National Institute for Health and Clinical Excellence. (2006). Parent-training/education programmes in the management of children with conduct disorders, Retrieved from

  • O’Neill, D., McGilloway, S., Donnelly, M., Bywater, T., & Kelly, P. (2011). A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities. The European Journal of Health Economics. doi:10.1007/s10198-011-0342-y. Advance online publication.

  • Olchowski, A. E., Foster, E. M., & Webster-Stratton, C. (2007). Implementing behavioural intervention components in a cost-effective manner. Journal of Early and Intensive Behaviour Intervention, 4, 284–304.

    Google Scholar 

  • Ridyard, C. H., & Hughes, D. A. (2010). Methods for the collection of resource use data within clinical trials: A systematic review of studies funded by the UK health technology assessment programme. Value in Health, 13, 867–872. doi:10.1111/j.1524-4733.2010.00788.x.

    Article  PubMed  Google Scholar 

  • Steckler, A., & McLeroy, K.R. (2008). The importance of external validity. American Journal of Public Health, 98, 9–10.

    Google Scholar 

  • Webster-Stratton, C. (2004). Quality training, supervision, ongoing monitoring, and agency support: Key ingredients to implementing. The Incredible Years programmes with fidelity. Retrieved from &nLibraryID = 446

  • Webster-Stratton, C., & Reid, M.J. (2010). In J. Weisz & A. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp.194–210). New York: Guilford Press.

  • Welsh Assembly Government (WAG). (2005). Flying Start. Retrieved from /publications/policy_strategy_and_planning/early-wales/flyingstart/ flyingstart.pdf? lang = en

Download references


The authors wish to acknowledge the support from the Welsh Assembly Government, the Welsh Health Economics Support Service (WHESS) for financial and academic support for the PhD studentship to carry out this micro-costing, and also the group leaders, service managers & IY Wales Centre, Bangor University for providing cost information.

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. M. Charles.

Electronic supplementary material

Below is the link to the electronic supplementary material.


(XLS 24 kb)

Supplementary Material Table 1

Total program costs from previous micro-costing exercises of parenting program. Costs are presented in their original published form, and as costs in Pounds Sterling inflated to 2008/09 costs. (DOC 39 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Charles, J.M., Edwards, R.T., Bywater, T. et al. Micro-Costing in Public Health Economics: Steps Towards a Standardized Framework, Using the Incredible Years Toddler Parenting Program as a Worked Example. Prev Sci 14, 377–389 (2013).

Download citation

  • Published:

  • Issue Date:

  • DOI: