Cost‐effectiveness of implant‐supported mandibular removable partial dentures. Issue 5 (14th April 2016)

• Record Type: Journal Article
• Authors: Jensen, Charlotte; Ross, Jamila; Feenstra, Talitha L.; Raghoebar, Gerry M.; Speksnijder, Caroline; Meijer, Henny J.A.; Cune, Marco S.
• Is Part Of: Clinical oral implants research. Volume 28:Issue 5(2017)
• Page Start: 594
• Page End: 601
• Publication Date: 2016-04-14
• Subjects: dental implants -- economic evaluation -- mastication -- patient outcomes -- quality of life -- removable prosthodontics; Dental implants -- Research -- Periodicals; 617.69
• DOI: 10.1111/clr.12840
• Languages: English
• ISSNs: 0905-7161

Abstract

Abstract: Objectives: The aim of this study was to conduct a cost‐effectiveness analysis comparing conventional removable partial dentures (RPDs) and implant‐supported RPDs (ISRPDs) treatment in patients with an edentulous maxilla and a bilateral free‐ending situation in the mandible. Material and methods: Thirty subjects were included. A new RPD was made and implant support was provided 3 months later. Treatment costs (opportunity costs and costs based on tariffs) were calculated. Treatment effect was expressed by means of the Dutch Oral Health Impact Profile questionnaire (OHIP‐NL49), a chewing ability test (Mixing Ability Index, MAI) and a short‐form health survey measuring perceived general health (SF‐36), which was subsequently converted into quality‐adjusted‐life‐years (QALYs). The incremental cost‐effectiveness ratio (ICER) was the primary outcome measure of cost‐effectiveness, comparing both treatment strategies. Results: The mean total opportunity costs were €981 (95% CI €971–€991) for the RPD treatment and €2.480 (95% CI €2.461–€2.500) for the ISRPD treatment. The total costs derived from the national tariff structure were €850 for the RPD treatment and €2.610 for the ISRPD treatment. The ICER for OHIP‐NL49 and MAI using the opportunity costs was €80 and €786, respectively. When using the tariff structure, corresponding ICERs were €94 and €921. The effect of supporting an RPD with implants when expressed in QALYs was negligible; hence an ICER was not determined. Conclusions: It is concluded that depending on the choice of outcome measure and monetary threshold, supporting an RPD with implants is cost‐effective when payers are willing to pay more than €80 per OHIP point gained. Per MAI point gained, an additional €786 has to be invested.