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The cost-effectiveness of oral health interventions: A systematic review of cost-utility analyses.

  • Hettiarachchi, Ruvini M1, 2
  • Kularatna, Sanjeewa3
  • Downes, Martin J1, 2
  • Byrnes, Joshua1, 2
  • Kroon, Jeroen2, 4
  • Lalloo, Ratilal5
  • Johnson, Newell W2, 4
  • Scuffham, Paul A1, 2
  • 1 Centre for Applied Health Economics, School of Medicine, Griffith University, Nathan, QLD, Australia. , (Australia)
  • 2 Menzies Health Institute Queensland, Griffith University, QLD, Australia. , (Australia)
  • 3 Australian Centre for Health Services Innovation, Queensland University of Technology, Kelvin Grove, QLD, Australia. , (Australia)
  • 4 School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia. , (Australia)
  • 5 School of Dentistry, University of Queensland, Herston, QLD, Australia. , (Australia)
Published Article
Community dentistry and oral epidemiology
Publication Date
Apr 01, 2018
DOI: 10.1111/cdoe.12336
PMID: 28925508


To assess the usage of cost-utility analysis (CUA) in oral health interventions and to evaluate the methods used and the reporting quality of CUA in publications on oral health interventions. A systematic review was performed on literature published between 2000 and 2016 where cost-utility analyses of oral health interventions were included. The reporting quality of these oral health CUAs was assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Of the 6637 publications identified initially, 23 met the inclusion criteria. Of these, 14 (61%) had been published in the last 6 years. Included studies were on oral cancer (n = 6), provision of dental prosthesis (n = 6), dental caries (n = 4), periodontal diseases (n = 3), antibiotic prophylaxis (n = 2), dento-facial anomalies (n = 1) and dental service provision (n = 1). Twenty-one studies were able to identify the most cost-effective intervention among the different options compared. Of the 23 studies identified, 15 (65%) used quality-adjusted life years (QALY) as the outcome measure, and 18 (78%) reported an incremental cost-effectiveness ratio. The economic perspective was clearly stated in 13 articles (57%). Twenty studies (87%) reported the discount rate, and 22 (96%) undertook sensitivity analysis. The reporting quality of studies, appraised by the CHEERS checklist, varied from 75% to 100% (median 92%). The use of CUAs in evaluation of oral health interventions has been increasing recently, especially from 2011 to 2016. The majority of CUA articles were of good reporting quality as assessed by the CHEERS checklist and were able to provide conclusions regarding the most cost-effective intervention among the different options compared: this will assist in healthcare decision-making and resource allocation. These positive outcomes of our study encourage wider use of CUAs within the dental and oral health professions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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