The Politics of Autism includes an extensive discussion of insurance and the regulation of autism service providers.
Autism treatment is a business. There are many good providers, with dedicated therapists who can help autistic people achieve remarkable outcomes. But there are a lot of substandard providers and outright scamsters, too. It is extremely difficult for parents to find reliable, standardized information about providers and the quality of the services they offer.
Marketdata LLC, a leading independent market research publisher since 1979, has released a new study, a 50-page report entitled: The U.S. Autism Treatment Market . The study traces the market from 2009-2022 Forecast, examining programs and medications used to treat children with autism. This is a little-researched, but growth niche market.
According to Research Director, John LaRosa: “Applied behavior analysis (ABA) has become widely accepted among health care professionals and is used in many schools and autism treatment clinics. Occupational and speech therapy are also used.”
Market Value… The U.S. autism treatment market was estimated to be valued at $1.85 billion as of 2016, growing to $1.87 billion in the current year. Marketdata forecasts 3.9% average yearly growth, to $2.23 billion by 2022. This could be conservative, as insurance coverage is improving.
ABA (applied behavioral analysis) programs are estimated to generate $1.07 billion in revenues this year, and prescription drugs for autism symptoms account for $800 million.
Patient Demographics…. Based on new government data that finds that 1 in 45 children in the United States, aged 3-17, have autism, Marketdata analysts estimate that there are 1.4 million children with autism. Another 700,000 adults have autism, having “aged out” of childrens’ programs. 81% of autistic children are male.
The total annual costs for children with ASD (autism spectrum disorder) in the United States were estimated to be between $11.5 billion and $60.9 billion -- a significant economic burden.
There are basically three types of ABA program providers: brick & mortar centers, community providers, and In-home therapists.
The “average” ABA center grosses about $821,000. Many are non-profit organizations. Many now have waiting lists and there is a shortage of qualified supervisors.
Insurance coverage is a problem, but the share of children with access to insurance coverage is expected to increase from the 36% level today. In addition, the number of self-funded private employers covering autism treatment continues to grow.
Venture capital firms are starting to take notice of investment opportunities in this market.
Data suggest that approximately 58 percent of patients with a diagnosis of childhood autism receive some type of pharmaceutical treatment. However, this segment of the market has been shrinking in value as concerns continue over side effects of drugs such as Risperdal. These drugs also face competition from cheaper generics, as patents have expired.
Nine large multi-site ABA program providers operate an estimated 296 brick and mortar centers and employ thousands of therapists. Together, they account for about $390 million in revenues—a 38% market share of ABA programs.As for the last point, note that Lovaas worked at UCLA and many of his students work in the region.
"Many autism treatment organizations, and some of the largest competitors, are located in California. This is due to the fact that funding for treatment programs has been in place there since the 1990s, prior to the insurance mandates that were later put into place.”, according to John LaRosa.
Many self-advocate object to "economic cost" analysis, arguing that it treats autistic people as burdens rather than contributors to society.
Finally, note the emphasis on children. Autistic youths grow into autistic adults, and they continue to need services. We know a good deal less about the fate of autistic adults.