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Economic Evaluations of Preventive Interventions for Dental Caries and Periodontitis: A Systematic Review
journal contribution
posted on 2023-02-07, 22:15 authored by Tan NguyenTan Nguyen, Utsana TonmukayakulUtsana Tonmukayakul, LKD Le, Hanny CalacheHanny Calache, Cathy MihalopoulosCathy MihalopoulosObjectives: To critically examine the methods used for full economic evaluations of preventive interventions for dental caries and periodontitis. Methods: Published literature post-2000 was searched to April 2021. Based on a developed intervention classification framework for dental caries and periodontitis, only universal, selective or indicated interventions were included in this review. The Drummond 10-point checklist was used for quality appraisal. Results: Of 3,007 unique records screened for relevance, 73 studies were reviewed. Most model-based studies (61/73) used cost-effectiveness analysis (49%) or cost-benefit analysis (28%). Trial-based studies (16/73) commonly used cost-effectiveness analysis (59%). Four studies used both economic evaluation methods. Sixty-four papers (88%) were on dental caries, eight papers (11%) focused on periodontitis, and one paper (1%) included both oral diseases; 72% of model-based and 82% of trial-based studies were of good quality. The most frequently investigated dental caries preventive interventions were water fluoridation (universal intervention; cost-saving or cost-effective), fissure sealant and fluoride varnish (selective and indicated interventions; cost-effectiveness outcomes were inconsistent). Supportive periodontal therapy with oral health education (indicated intervention; cost-effective) was the most frequently evaluated preventive intervention for periodontitis. Thirty percent of studies with a time horizon > 1 year did not apply an appropriate discount rate and 26% did not comprehensively discuss other important considerations beyond the technical analysis. Conclusions: Generic health outcome measures should be incorporated for economic evaluations on preventive interventions for dental caries and periodontitis, and an increased focus to prevent periodontitis using economic evaluation methods is needed to inform resource allocation and policy decision-making.
History
Journal
Applied Health Economics and Health PolicyVolume
21Pagination
53-70Location
Berlin, GermanyPublisher DOI
ISSN
1175-5652eISSN
1179-1896Language
EnglishPublication classification
C1 Refereed article in a scholarly journalIssue
1Publisher
SpringerUsage metrics
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Keywords
Business & EconomicsCLINICAL-TRIALCOMMUNITY WATER FLUORIDATIONCOST-EFFECTIVENESS ANALYSISEconomicsGLOBAL BURDENHealth Care Sciences & ServicesHEALTH INTERVENTIONSHealth Policy & ServicesHIGH-RISK POPULATIONLife Sciences & BiomedicineMANAGEMENT-SYSTEMMINIMIZATION ANALYSISORAL-DISEASESRANDOMIZED CONTROLLED-TRIALScience & TechnologySocial SciencesHumansCost-Benefit AnalysisCost-Effectiveness AnalysisDental CariesPeriodontitisPit and Fissure SealantsFluoridationFluorides, TopicalOral HygieneHealth EducationCost Effectiveness ResearchPreventionComparative Effectiveness ResearchInfectious DiseasesDental/Oral and Craniofacial DiseaseOral and gastrointestinal3 Good Health and Well BeingApplied Economics not elsewhere classifiedPublic Health and Health Services not elsewhere classifiedMarketing not elsewhere classified
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