Economic Evaluation on Dental Caries Preventive Interventions for Children Using a Priority-Setting Approach in Australia
Author(s)
Tan Minh Nguyen, MPH, MSc1, Long Khanh-Dao Le, PhD1, Hanny Calache, DPH2, Cathy Mihalopoulos, PhD1.
1Health Economics Group, Public Health and Preventive Medicine, Monash University, Melbourne, Australia, 2Deakin Health Economics, Institute for Health Transformation, Deakin University, Waurn Ponds, Australia.
1Health Economics Group, Public Health and Preventive Medicine, Monash University, Melbourne, Australia, 2Deakin Health Economics, Institute for Health Transformation, Deakin University, Waurn Ponds, Australia.
OBJECTIVES: To economically evaluate three preventive interventions for dental caries among Australian children from low household income. The interventions included: 1. anticipatory guidance provided by oral health therapists via 1a) home visits or 1b) telehealth consultations; 2. school-based dental screening and fluoride varnish program delivered by 2a) dental practitioners or 2b) non-dental health professionals (no screening); and 3. school-based fissure sealant program
METHODS: Modelling from the healthcare perspective was adapted using a previously published dental caries model. The base-case scenario included intervention and dental treatment costs, with six-year (1a and 1b) and two-year (2a, 2b and 3) time horizons. Sensitivity analysis included other healthcare costs (e.g. pulp therapy, extractions, etc.). Additionally, extrapolation modelling was extended to the 12-year time horizon (all interventions). Probability for cost-effectiveness applied AUD$50,000 per disability-adjusted life year (DALY) averted, and AUD$28,033 per quality-adjusted life year (QALY) gained willingness-to-pay thresholds.
RESULTS: Under the base-case scenario, none of the interventions were cost-effective and this conclusion did not significantly vary with sensitivity analysis. Probability for cost-effectiveness (DALYs averted/QALYs gained) with extrapolation modelling in order of ranking were: 1) 91.5%/94.7% for fluoride varnish, 2) 43.9%/48.6% for dental screening and fluoride varnish, 3) 28.7%/29.8% for anticipatory guidance via telehealth, 4) 17.1%/20.0% for fissure sealant, and 5) 2.2%/2.2% for anticipatory guidance via home visits
CONCLUSIONS: The three preventive interventions for dental caries modelled in this study were found to not be cost-effective with the base-case scenario. The results were sensitive when including other healthcare costs and applying the 12-year time horizon.
METHODS: Modelling from the healthcare perspective was adapted using a previously published dental caries model. The base-case scenario included intervention and dental treatment costs, with six-year (1a and 1b) and two-year (2a, 2b and 3) time horizons. Sensitivity analysis included other healthcare costs (e.g. pulp therapy, extractions, etc.). Additionally, extrapolation modelling was extended to the 12-year time horizon (all interventions). Probability for cost-effectiveness applied AUD$50,000 per disability-adjusted life year (DALY) averted, and AUD$28,033 per quality-adjusted life year (QALY) gained willingness-to-pay thresholds.
RESULTS: Under the base-case scenario, none of the interventions were cost-effective and this conclusion did not significantly vary with sensitivity analysis. Probability for cost-effectiveness (DALYs averted/QALYs gained) with extrapolation modelling in order of ranking were: 1) 91.5%/94.7% for fluoride varnish, 2) 43.9%/48.6% for dental screening and fluoride varnish, 3) 28.7%/29.8% for anticipatory guidance via telehealth, 4) 17.1%/20.0% for fissure sealant, and 5) 2.2%/2.2% for anticipatory guidance via home visits
CONCLUSIONS: The three preventive interventions for dental caries modelled in this study were found to not be cost-effective with the base-case scenario. The results were sensitive when including other healthcare costs and applying the 12-year time horizon.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD286
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Pediatrics