PSS44 - Preferences of The General Population To Avoid Oral Health Outcomes: Results of A Bayesian Discrete Choice Experiment

Abstract

Paucity of data on quality of life associated with oral health conditions and concerns over using generic measures has led to alternative approaches being used to value prevention of oral health problems. The purpose of this study was to obtain willingness-to-pay (WTP) values for preventing oral ill-health to inform economic modelling, using a discrete choice experiment (DCE). The first stage of the DCE was to identify attributes and levels associated with specific oral health problems (tooth decay and gum disease). This was informed by health states expected to be included in an oral health economic model and a focussed literature review. Pretesting was conducted, followed by two surveys administered online to UK general population panel. The DCE study included a cost attribute to estimate respondents’ WTP to avoid specific oral health problems. A Bayesian D-efficient design was employed using estimates from first survey as informative priors in the final statistical design. Attributes were defined according to the type of tooth affected (molar, pre-molar, anterior), gum disease and cost. The levels within tooth attributes were: no problem, decay without pain, decay with pain and tooth requiring removal. Coefficients and standard errors from the first survey (N=944), were used to inform the second survey (N=1047). Conditional logit model reflecting repeated observations from the same individuals was fitted to the data. The model was statistically significant. Avoiding problems in anterior teeth was most highly valued followed by premolar and molar teeth. Avoiding decay with pain in an anterior tooth generated the highest WTP (mean £245; 95% CI £216 to 272) followed by removal of anterior tooth (mean £203; £169 to £235). Results demonstrate that people have stronger preferences to avoid problems with anterior teeth compared to pre-molars and molars. Prevention of gum problems are also highly valued by respondents.