The cost-utility of school-based first permanent molar sealants programs: a Markov model
Abstract Background Evidence of the cost-effectiveness of school-based first permanent molar sealants programs is not yet fully conclusive. The aim of this study was to determine the incremental cost-utility ratio (ICUR) of school-based prevention programs for the application of sealants in molars o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-019-0990-3 |
| _version_ | 1818364098084077568 |
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| author | Gerardo Espinoza-Espinoza Gilda Corsini Rubén Rojas Rodrigo Mariño Carlos Zaror |
| author_facet | Gerardo Espinoza-Espinoza Gilda Corsini Rubén Rojas Rodrigo Mariño Carlos Zaror |
| author_sort | Gerardo Espinoza-Espinoza |
| collection | DOAJ |
| description | Abstract Background Evidence of the cost-effectiveness of school-based first permanent molar sealants programs is not yet fully conclusive. The aim of this study was to determine the incremental cost-utility ratio (ICUR) of school-based prevention programs for the application of sealants in molars of schoolchildren compared with non-intervention. Methods A cost-utility analysis based on a Markov model was carried out using probability distribution. The utility was measured in quality-adjusted tooth years (QATY). The assessment was carried out from the public payer’s perspective with a six-year time horizon. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) at 7th May at 2019 values (exchange rate USD = CLP 681.09). Univariate deterministic sensitivity analysis and probabilistic analysis were carried out. Results After a six-year follow up, the cost of sealing all first permanent molars was found to be higher than non-intervention, with a mean cost difference of USD 1.28 (CLP 875) per molar treated. The “seal all” strategy was more effective than non-intervention, generating 0.2 quality-adjusted tooth years more than non-intervention. The ICUR of the “seal all” strategy compared to non-intervention was USD 6.48 (CLP 4,412) per quality-adjusted tooth years. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICUR. Conclusions A school-based sealant program is a cost-effective measure in populations with a high prevalence of caries. |
| first_indexed | 2024-12-13T21:58:58Z |
| format | Article |
| id | doaj.art-abe12d899e5546508be15555e80961ac |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-12-13T21:58:58Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-abe12d899e5546508be15555e80961ac2022-12-21T23:30:04ZengBMCBMC Oral Health1472-68312019-12-0119111110.1186/s12903-019-0990-3The cost-utility of school-based first permanent molar sealants programs: a Markov modelGerardo Espinoza-Espinoza0Gilda Corsini1Rubén Rojas2Rodrigo Mariño3Carlos Zaror4Department of Public Health, Faculty of Medicine, Universidad de La FronteraCenter for Research and Innovation in Clinical Dentistry (CIDIC), Faculty of Dentistry, Universidad de La FronteraSchool of Health and Related Research (ScHARR), The University of SheffieldMelbourne Dental School, The University of MelbourneCenter for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La FronteraAbstract Background Evidence of the cost-effectiveness of school-based first permanent molar sealants programs is not yet fully conclusive. The aim of this study was to determine the incremental cost-utility ratio (ICUR) of school-based prevention programs for the application of sealants in molars of schoolchildren compared with non-intervention. Methods A cost-utility analysis based on a Markov model was carried out using probability distribution. The utility was measured in quality-adjusted tooth years (QATY). The assessment was carried out from the public payer’s perspective with a six-year time horizon. Costs and benefits were discounted at 3% per year. Only direct costs were evaluated, expressed in Chilean pesos (CLP) at 7th May at 2019 values (exchange rate USD = CLP 681.09). Univariate deterministic sensitivity analysis and probabilistic analysis were carried out. Results After a six-year follow up, the cost of sealing all first permanent molars was found to be higher than non-intervention, with a mean cost difference of USD 1.28 (CLP 875) per molar treated. The “seal all” strategy was more effective than non-intervention, generating 0.2 quality-adjusted tooth years more than non-intervention. The ICUR of the “seal all” strategy compared to non-intervention was USD 6.48 (CLP 4,412) per quality-adjusted tooth years. The sensitivity analysis showed that the increase in caries was the variable which most influenced the ICUR. Conclusions A school-based sealant program is a cost-effective measure in populations with a high prevalence of caries.https://doi.org/10.1186/s12903-019-0990-3Pit and fissure sealantsDental cariesPreventionCost-effectiveness analysis |
| spellingShingle | Gerardo Espinoza-Espinoza Gilda Corsini Rubén Rojas Rodrigo Mariño Carlos Zaror The cost-utility of school-based first permanent molar sealants programs: a Markov model BMC Oral Health Pit and fissure sealants Dental caries Prevention Cost-effectiveness analysis |
| title | The cost-utility of school-based first permanent molar sealants programs: a Markov model |
| title_full | The cost-utility of school-based first permanent molar sealants programs: a Markov model |
| title_fullStr | The cost-utility of school-based first permanent molar sealants programs: a Markov model |
| title_full_unstemmed | The cost-utility of school-based first permanent molar sealants programs: a Markov model |
| title_short | The cost-utility of school-based first permanent molar sealants programs: a Markov model |
| title_sort | cost utility of school based first permanent molar sealants programs a markov model |
| topic | Pit and fissure sealants Dental caries Prevention Cost-effectiveness analysis |
| url | https://doi.org/10.1186/s12903-019-0990-3 |
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