REAL-WORLD COST-UTILITY EVIDENCE SUPPORTING ORAL HEALTH INTEGRATION IN DIABETES CARE IN CHILE
Author(s)
Mauricio Baeza, PhD, Carol Chandia, DDS, Matias Chavez, DDS, Fabiola Werlinger, PhD, Marianela Castillo, PhD, Jorge Gamonal, PhD.
University of Chile, Santiago, Chile.
University of Chile, Santiago, Chile.
OBJECTIVES: To evaluate the cost-utility of integrating comprehensive oral healthcare into diabetes management in Chile and to assess whether cost-utility differs according to baseline metabolic control.
METHODS: A prospective real-world matched cohort study was conducted in Chilean public primary healthcare centers. Adults with type 2 diabetes mellitus (T2DM) receiving comprehensive oral healthcare in addition to usual chronic disease management were compared with those receiving usual chronic disease management alone using 1:1 propensity score matching. Changes in glycated hemoglobin (HbA1c) and systolic blood pressure associated with oral healthcare were incorporated into an individual-level lifetime microsimulation model based on UKPDS equations. Outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICURs). A willingness-to-pay threshold equivalent to Chile’s gross domestic product per capita (2025 value: US$17,735 per QALY gained) was applied. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: Comprehensive oral healthcare improved cardiometabolic outcomes compared with usual chronic disease management alone and was cost-effective for the Chilean public health system. The greatest economic benefit was observed among individuals with poorer baseline metabolic control (HbA1c ≥7%), with an ICUR of US$6,886 per QALY gained, well below the national willingness-to-pay threshold. In contrast, cost-utility was less favorable among individuals who had already achieved metabolic control targets at baseline. Deterministic and probabilistic sensitivity analyses showed consistent findings across evaluated parameter ranges.
CONCLUSIONS: Integrating oral healthcare into diabetes management may represent a cost-effective strategy for strengthening chronic disease management in Chile. These findings provide real-world economic evidence supporting the incorporation of oral healthcare into integrated care strategies within public health systems.
METHODS: A prospective real-world matched cohort study was conducted in Chilean public primary healthcare centers. Adults with type 2 diabetes mellitus (T2DM) receiving comprehensive oral healthcare in addition to usual chronic disease management were compared with those receiving usual chronic disease management alone using 1:1 propensity score matching. Changes in glycated hemoglobin (HbA1c) and systolic blood pressure associated with oral healthcare were incorporated into an individual-level lifetime microsimulation model based on UKPDS equations. Outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICURs). A willingness-to-pay threshold equivalent to Chile’s gross domestic product per capita (2025 value: US$17,735 per QALY gained) was applied. Deterministic and probabilistic sensitivity analyses were conducted.
RESULTS: Comprehensive oral healthcare improved cardiometabolic outcomes compared with usual chronic disease management alone and was cost-effective for the Chilean public health system. The greatest economic benefit was observed among individuals with poorer baseline metabolic control (HbA1c ≥7%), with an ICUR of US$6,886 per QALY gained, well below the national willingness-to-pay threshold. In contrast, cost-utility was less favorable among individuals who had already achieved metabolic control targets at baseline. Deterministic and probabilistic sensitivity analyses showed consistent findings across evaluated parameter ranges.
CONCLUSIONS: Integrating oral healthcare into diabetes management may represent a cost-effective strategy for strengthening chronic disease management in Chile. These findings provide real-world economic evidence supporting the incorporation of oral healthcare into integrated care strategies within public health systems.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE84
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), STA: Multiple/Other Specialized Treatments