The use of cost-utility analysis for the evaluation of caries prevention: an exploratory case study of two community-based public health interventions in a high-risk population in the UK.

Abstract

Economic evaluations are important tools for decision makers to determine the best allocation of resources in a healthcare system. This study explored the use of economic evaluation in oral health promotion. A literature review identified oral health promotion programmes that measured both the health impact and costs of oral health interventions. A decision analysis model was constructed to examine the cost utility of preventing dental caries in 5 and 12-year-old children via tooth brushing schemes and fluoride varnish programmes. The costs per child that would be justified according to the National Institute for Health and Care Excellence's threshold of £20,000 per QALY were calculated. The analysis showed that NICE would consider that the expenditure of £55 per child on supervised tooth brushing, or £100 per child on fluoride varnish application would give sufficient health benefits to be justified according to their threshold. Greater attention needs to be paid to the collection of robust data on costs for oral health promotion. Dental researchers also urgently need to collect outcome data in a form that can be translated into a Quality of Life measure, so that the true cost effectiveness and value for money achieved through the prevention of dental disease can be recognised and compared to other allocations of resource.