Cost-Effectiveness of Periodontitis Management in Public Sector Specialist Periodontal Clinics

A Societal Perspective Research in Malaysia

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease. Methods: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs. Results: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively. Conclusions: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.

Original languageEnglish
Pages (from-to)117-123
Number of pages7
JournalValue in Health Regional Issues
Volume3
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Public Sector
Periodontitis
Malaysia
Cost-Benefit Analysis
Quality-Adjusted Life Years
Tooth
Research
Costs and Cost Analysis
Critical Pathways
Periodontal Diseases
Therapeutics
Health Care Costs
Uncertainty
Public sector
Cost-effectiveness
Outpatients
Quality-adjusted life years
Incremental cost
Costs
Cost-effectiveness analysis

Keywords

  • Cost-effectiveness
  • Malaysia
  • Oral health care delivery
  • Periodontal disease
  • Specialist periodontal treatment

ASJC Scopus subject areas

  • Health Policy
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Economics, Econometrics and Finance (miscellaneous)

Cite this

@article{0d576fe272c445899ee14b286120fa99,
title = "Cost-Effectiveness of Periodontitis Management in Public Sector Specialist Periodontal Clinics: A Societal Perspective Research in Malaysia",
abstract = "Objectives: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease. Methods: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs. Results: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively. Conclusions: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.",
keywords = "Cost-effectiveness, Malaysia, Oral health care delivery, Periodontal disease, Specialist periodontal treatment",
author = "{Mohd Dom}, {Tuti Ningseh} and {Wan Puteh}, {Sharifa Ezat} and Amrizal Muhd-Nur and Rasidah Ayob and {Abdul Manaf}, {Mohd Rizal} and Khairiyah Abdul-Muttalib and {Syed Junid}, {Syed Mohamed Al-Junid}",
year = "2014",
doi = "10.1016/j.vhri.2014.04.012",
language = "English",
volume = "3",
pages = "117--123",
journal = "Value in Health Regional Issues",
issn = "2212-1099",
publisher = "Elsevier USA",
number = "1",

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TY - JOUR

T1 - Cost-Effectiveness of Periodontitis Management in Public Sector Specialist Periodontal Clinics

T2 - A Societal Perspective Research in Malaysia

AU - Mohd Dom, Tuti Ningseh

AU - Wan Puteh, Sharifa Ezat

AU - Muhd-Nur, Amrizal

AU - Ayob, Rasidah

AU - Abdul Manaf, Mohd Rizal

AU - Abdul-Muttalib, Khairiyah

AU - Syed Junid, Syed Mohamed Al-Junid

PY - 2014

Y1 - 2014

N2 - Objectives: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease. Methods: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs. Results: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively. Conclusions: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.

AB - Objectives: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease. Methods: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs. Results: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively. Conclusions: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.

KW - Cost-effectiveness

KW - Malaysia

KW - Oral health care delivery

KW - Periodontal disease

KW - Specialist periodontal treatment

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DO - 10.1016/j.vhri.2014.04.012

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JO - Value in Health Regional Issues

JF - Value in Health Regional Issues

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