ASSESSING COST-EFFECTIVENESS ON ORAL HEALTH PREVENTIVE INTERVENTIONS (ACE-ORAL HEALTH PREVENTION)
Author(s)
Tan Nguyen, MPH, MSc1, Long Khanh-Dao Le, MPH, PhD2, Hanny Calache, DrPH3, Cathy Mihalopoulos, PhD4.
1PhD Candidate, Deakin University, Bulleen, Australia, 2Monash University, Melbourne, Australia, 3Deakin University, Waurn Ponds, Australia, 4Monash University, Clayton, Australia.
1PhD Candidate, Deakin University, Bulleen, Australia, 2Monash University, Melbourne, Australia, 3Deakin University, Waurn Ponds, Australia, 4Monash University, Clayton, Australia.
OBJECTIVES: This research addresses a critical policy gap in Australia's healthcare system, where dental services are largely excluded from universal public health insurance, Medicare. The result is significant inequities in oral healthcare access, particularly for disadvantaged communities with poorer oral health. The study objective evaluated the cost-effectiveness of preventive interventions for dental caries and periodontitis using the Assessing Cost-Effectiveness (ACE) framework.
METHODS: Using the ACE priority-setting framework, a Project Steering Group (PSG) consisting of consumer representatives, academics, and policymakers was established. The PSG selected six preventive interventions for economic modelling: anticipatory guidance provided by oral health therapists, implementing a sugar-sweetened beverage (SSB) tax, targeted school-based fissure sealant/fluoride varnish programs, applying the Caries Management System protocol (a Minimally Invasive Dentistry approach), and tobacco cessation services. The study used disability-adjusted life years (DALYs) and the primary outcome, with the explicit willingness-to-pay (WTP) threshold of AUD$50,000 per DALY averted. Secondary outcome measures used decayed teeth prevented (DT-prevented) and quality-adjusted life years (QALYs), where appropriate. Costs and outcomes had a 5% discount rate applied.
RESULTS: A valoric 20% SSB tax emerged as the only cost-effective intervention, resulting in modelled projected net cost-savings of AUD$64 million from a societal perspective and 98 DALYs averted over 10 years. All other interventions were not cost-effective. When ranked by the DT-prevented outcome, the SSB tax remained most cost-effective, which was followed by utilising non-dental professionals to implement a targeted school-based fluoride varnish program.
CONCLUSIONS: A universal intervention such as 20% valoric SSB tax, can promote oral health equity while generating cost-savings. Utilising non-dental health professionals can increase cost-effectiveness. Most clinical preventive interventions did not demonstrate value for money under the current WTP threshold, highlighting caution in designing oral health policy for resource allocation. Further research is needed to incorporate broader health co-benefits of oral health preventive interventions.
METHODS: Using the ACE priority-setting framework, a Project Steering Group (PSG) consisting of consumer representatives, academics, and policymakers was established. The PSG selected six preventive interventions for economic modelling: anticipatory guidance provided by oral health therapists, implementing a sugar-sweetened beverage (SSB) tax, targeted school-based fissure sealant/fluoride varnish programs, applying the Caries Management System protocol (a Minimally Invasive Dentistry approach), and tobacco cessation services. The study used disability-adjusted life years (DALYs) and the primary outcome, with the explicit willingness-to-pay (WTP) threshold of AUD$50,000 per DALY averted. Secondary outcome measures used decayed teeth prevented (DT-prevented) and quality-adjusted life years (QALYs), where appropriate. Costs and outcomes had a 5% discount rate applied.
RESULTS: A valoric 20% SSB tax emerged as the only cost-effective intervention, resulting in modelled projected net cost-savings of AUD$64 million from a societal perspective and 98 DALYs averted over 10 years. All other interventions were not cost-effective. When ranked by the DT-prevented outcome, the SSB tax remained most cost-effective, which was followed by utilising non-dental professionals to implement a targeted school-based fluoride varnish program.
CONCLUSIONS: A universal intervention such as 20% valoric SSB tax, can promote oral health equity while generating cost-savings. Utilising non-dental health professionals can increase cost-effectiveness. Most clinical preventive interventions did not demonstrate value for money under the current WTP threshold, highlighting caution in designing oral health policy for resource allocation. Further research is needed to incorporate broader health co-benefits of oral health preventive interventions.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE39
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas