Abstract
This study aimed to estimate cost and compatibility with public financial incentives of two technologies for treating the edentulous mandible: lower complete dentures (CD) and overdentures retained by two dental implants (OD). This study consisted of a partial economic evaluation, with a micro-costing bottom-up approach for the calculation of direct costs. The estimates involved the number of consultations, proportion of materials, equipment, instruments' lifetime, and human resources, described in the price panel website of the Ministry of Economy in Brazil. Complementary information was obtained from a panel of experts. A sensitivity analysis was based on 20% variation. The estimated cost of a CD was R$ 189.89 (base scenario), and this varied between R$ 151.91 and R$ 227.89 according to sensibility analysis. The cost of an OD was R$ 663.05 (ranging from R$ 795.66 to R$ 530.44 - 1US=R$ 3.80/July 2019). The Ministry of Health covers appropriately the costs of the CD and OD. Both technologies showed costs that are within the limits of financial public incentives obtained by municipalities. The technologies are economically viable and should be induced through public policies due to their positive impacts on several functional domains of health.
Highlights
The financing system of the public health sector in Brazil isregulated by different laws
This study aimed to estimate cost and compatibility with public financial incentives of two technologies for treating the edentulous mandible: lower complete dentures (CD) and overdentures retained by two dental implants (OD)
Direct costs for manufacturing lower conventional dentures and complete dentures retained by two implants were calculated from the perspective of the Brazilian public health system (SUS, through Smiling Brazil Program)
Summary
The financing system of the public health sector in Brazil isregulated by different laws. Diverse strategies have limited the financing and expenditure towardspublic health in Brazil These measures result from a peculiar political-economic scenario, caused by a severe economic recession, with a reduction in the Gross National Product (GNP) by approximately 6% from 2014 to 2017. This context has resulted in a breakdown of the Ministry of Health policies, due to the constant changes, which have not always been compatible with the collective interests. Making the public health system more efficient maximizes the health service and makes expenditures more rational In this context, demand shows an upward trend and resources progressively fall[2]. The production of economic evaluation studies with application to the Brazilian public health system (SUS) has been modest[3,4], so the costs analysis in oral health are rare[5,6]
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