IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0086992.html
   My bibliography  Save this article

Costs and Effectiveness of Treatment Alternatives for Proximal Caries Lesions

Author

Listed:
  • Falk Schwendicke
  • Hendrik Meyer-Lueckel
  • Michael Stolpe
  • Christof Edmund Dörfer
  • Sebastian Paris

Abstract

Objectives: Invasive therapy of proximal caries lesions initiates a cascade of re-treatment cycles with increasing loss of dental hard tissue. Non- and micro-invasive treatment aim at delaying this cascade and may thus reduce both the health and economic burden of such lesions. This study compared the costs and effectiveness of alternative treatments of proximal caries lesions. Methods: A Markov-process model was used to simulate the events following the treatment of a proximal posterior lesion (E2/D1) in a 20-year-old patient in Germany. We compared three interventions (non-invasive; micro-invasive using resin infiltration; invasive using composite restoration). We calculated the risk of complications of initial and possible follow-up treatments and modelled time-dependent non-linear transition probabilities. Costs were calculated based on item-fee catalogues in Germany. Monte-Carlo-microsimulations were performed to compare cost-effectiveness of non- versus micro-invasive treatment and to analyse lifetime costs of all three treatments. Results: Micro-invasive treatment was both more costly and more effective than non-invasive therapy, with ceiling-value-thresholds for willingness-to-pay between 16.73 € for E2 and 1.57 € for D1 lesions. Invasive treatment was the most costly strategy. Calculated costs and effectiveness were sensitive to lesion stage, patient’s age, discounting rate and assumed initial treatment costs. Conclusions: Non- and micro-invasive treatments have lower long-term costs than invasive therapy of proximal lesions. Micro-invasive therapy had the highest cost-effectiveness for treating D1 lesions in young patients. Decision makers with a willingness-to-pay over 16.73 € and 1.57 € for E2 and D1 lesions, respectively, will find micro-invasive treatment more cost-effective than non-invasive therapy.

Suggested Citation

  • Falk Schwendicke & Hendrik Meyer-Lueckel & Michael Stolpe & Christof Edmund Dörfer & Sebastian Paris, 2014. "Costs and Effectiveness of Treatment Alternatives for Proximal Caries Lesions," PLOS ONE, Public Library of Science, vol. 9(1), pages 1-10, January.
    • Handle: RePEc:plo:pone00:0086992
    DOI: 10.1371/journal.pone.0086992
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0086992
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0086992&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0086992?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits," Medical Decision Making, , vol. 18(2_suppl), pages 68-80, April.
    2. Aaron A. Stinnett & John Mullahy, 1998. "Net Health Benefits: A New Framework for the Analysis of Uncertainty in Cost-Effectiveness Analysis," NBER Technical Working Papers 0227, National Bureau of Economic Research, Inc.
    3. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Zhi Qu & Shanshan Zhang & Christian Krauth & Xuenan Liu, 2019. "A systematic review of decision analytic modeling techniques for the economic evaluation of dental caries interventions," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-17, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Simon Eckermann & Tim Coelli, 2008. "Including quality attributes in a model of health care efficiency: A net benefit approach," CEPA Working Papers Series WP032008, School of Economics, University of Queensland, Australia.
    2. Emma McIntosh, 2006. "Using Discrete Choice Experiments within a Cost-Benefit Analysis Framework," PharmacoEconomics, Springer, vol. 24(9), pages 855-868, September.
    3. Helen Dakin & Sarah Wordsworth, 2013. "Cost‐Minimisation Analysis Versus Cost‐Effectiveness Analysis, Revisited," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 22-34, January.
    4. Eckermann, Simon & Coelli, Tim, 2013. "Including quality attributes in efficiency measures consistent with net benefit: Creating incentives for evidence based medicine in practice," Social Science & Medicine, Elsevier, vol. 76(C), pages 159-168.
    5. Hoch, Jeffrey S. & Blume, Jeffrey D., 2008. "Measuring and illustrating statistical evidence in a cost-effectiveness analysis," Journal of Health Economics, Elsevier, vol. 27(2), pages 476-495, March.
    6. Casey Quinn, 2005. "Generalisable regression methods for costeffectiveness using copulas," Health, Econometrics and Data Group (HEDG) Working Papers 05/13, HEDG, c/o Department of Economics, University of York.
    7. Lynch, Frances L. & Dickerson, John F. & Pears, Katherine C. & Fisher, Philip A., 2017. "Cost effectiveness of a school readiness intervention for foster children," Children and Youth Services Review, Elsevier, vol. 81(C), pages 63-71.
    8. Nikki McCaffrey & Meera Agar & Janeane Harlum & Jonathon Karnon & David Currow & Simon Eckermann, 2015. "Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-19, March.
    9. Nicola E Stanczyk & Eline S Smit & Daniela N Schulz & Hein de Vries & Catherine Bolman & Jean W M Muris & Silvia M A A Evers, 2014. "An Economic Evaluation of a Video- and Text-Based Computer-Tailored Intervention for Smoking Cessation: A Cost-Effectiveness and Cost-Utility Analysis of a Randomized Controlled Trial," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-14, October.
    10. Moreno, Elías & Girón, F.J. & Vázquez-Polo, F.J. & NegrI´n, M.A., 2010. "Optimal healthcare decisions: Comparing medical treatments on a cost-effectiveness basis," European Journal of Operational Research, Elsevier, vol. 204(1), pages 180-187, July.
    11. Jeffrey Hoch & Carolyn Dewa, 2007. "Lessons from Trial-Based Cost-Effectiveness Analyses of Mental Health Interventions," PharmacoEconomics, Springer, vol. 25(10), pages 807-816, October.
    12. Sennen Hounton & David Newlands, 2012. "Applying the Net-Benefit Framework for Analyzing and Presenting Cost-Effectiveness Analysis of a Maternal and Newborn Health Intervention," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
    13. Wildman, John & McMeekin, Peter & Grieve, Eleanor & Briggs, Andrew, 2016. "Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators," Social Science & Medicine, Elsevier, vol. 169(C), pages 141-148.
    14. Manuel Antonio Espinoza & Andrea Manca & Karl Claxton & Mark Sculpher, 2018. "Social value and individual choice: The value of a choice‐based decision‐making process in a collectively funded health system," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 28-40, February.
    15. A. E. Ades & Karl Claxton & Mark Sculpher, 2006. "Evidence synthesis, parameter correlation and probabilistic sensitivity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 373-381, April.
    16. Basu, Anirban & Jena, Anupam B. & Philipson, Tomas J., 2011. "The impact of comparative effectiveness research on health and health care spending," Journal of Health Economics, Elsevier, vol. 30(4), pages 695-706, July.
    17. Karl Claxton & Elisabeth Fenwick & Mark J. Sculpher, 2012. "Decision-making with Uncertainty: The Value of Information," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 51, Edward Elgar Publishing.
    18. Frank G. Sandmann & Julie V. Robotham & Sarah R. Deeny & W. John Edmunds & Mark Jit, 2018. "Estimating the opportunity costs of bed‐days," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 592-605, March.
    19. Clarke, Philip M. & Hayes, Alison J., 2009. "Measuring achievement: Changes in risk factors for cardiovascular disease in Australia," Social Science & Medicine, Elsevier, vol. 68(3), pages 552-561, February.
    20. Niklas Zethraeus & Magnus Johannesson & Bengt Jönsson & Mickael Löthgren & Magnus Tambour, 2003. "Advantages of Using the Net-Benefit Approach for Analysing Uncertainty in Economic Evaluation Studies," PharmacoEconomics, Springer, vol. 21(1), pages 39-48, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0086992. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.