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Published in: BMC Oral Health 1/2018

Open Access 01-12-2018 | Research article

Cost-effectiveness analysis of a school-based dental caries prevention program using fluoridated milk in Bangkok, Thailand

Authors: Rodrigo Mariño, Fernando Traub, Puangtong Lekfuangfu, Kornkamol Niyomsilp

Published in: BMC Oral Health | Issue 1/2018

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Abstract

Background

This study modelled the cost-effectiveness, from a societal perspective, of a program that used fluoridated milk to prevent dental caries in children who were 6 years old at the beginning of the program, versus non-intervention, after 6 years.

Methods

After 6 years, children in the milk-fluoridation program had a significant (34%) reduction in dental caries experience compared to those in the comparison community (i.e., received school milk without added fluoride) (DMFS: 1.06 vs. 1.60).

Results

This improvement was achieved with an investment of Thailand Baht (THB) 5,345,048 over 6 years (or THB 11.88 per child, per year) (1 US$ = THB(2011) 30.0). When comparing the costs of the operation of the program and dental treatment in the test community with those of the comparison community, the program resulted in a net societal savings of THB 8,177,179 (range 18,597,122 to THB 7,920,711) after 6 years. This investment would result in 40,500 DMFS avoided in a community with a childhood population of 75,000 [DMFS avoided: 75,000 x (− 0.54)].

Conclusions

While the analysis has inherent limitations due to its dependence on a range of assumptions, the results suggest that, from a societal perspective, when compared with the non-intervention group, the Bangkok Metropolitan Administration intervention appeared to be a more cost-efficient option than current standard oral health care.
Footnotes
1
The Royal Chitralada Projects are projects based in Chitralada Villa, the royal residence of their Majesties the King and Queen in Bangkok, conducted to tests and experiments in agriculture and agricultural products. The Chitralada Villa include rice fields, fish ponds, a dairy farm, tissue culture plant and various kinds of pilot factories. Wattana T. The Royal Chitralada Projects initiated by H.M. King Bhumibol. 2002. http://​www.​thaiwaysmagazine​.​com/​thai_​article/​30-07_​the_​royal_​chitralada/​the_​royal_​chitralada.​html. (accessed 14.10.17)
 
Literature
1.
go back to reference Centers for Disease Control and Prevention. Fluoridation of public drinking water to prevent dental caries. MMW. 1999;48:933–90. Centers for Disease Control and Prevention. Fluoridation of public drinking water to prevent dental caries. MMW. 1999;48:933–90.
2.
go back to reference Künzel W. Systemic use of fluoride-other methods: salt, sugar, milk, etc. Caries Res. 1993;27(Suppl 1):16–22.CrossRefPubMed Künzel W. Systemic use of fluoride-other methods: salt, sugar, milk, etc. Caries Res. 1993;27(Suppl 1):16–22.CrossRefPubMed
4.
go back to reference Mariño R. Se debe fluorurar la leche? Bol Oficina Sanit Panam. 1996;75:98–109. Mariño R. Se debe fluorurar la leche? Bol Oficina Sanit Panam. 1996;75:98–109.
5.
go back to reference World Health Organization. Fluorides and oral health. Report of a WHO expert committee on oral health status and fluoride use. WHO Technical Report Series 846. Geneva: World Health Organization; 1994. World Health Organization. Fluorides and oral health. Report of a WHO expert committee on oral health status and fluoride use. WHO Technical Report Series 846. Geneva: World Health Organization; 1994.
7.
go back to reference Carande-Kulis VG, Maciosek MV, Briss PA, Teutsch SM, Zaza S, Truman BI, Messonnier ML, Pappaioanou M, Harris JR, Fielding J. Methods for systematic reviews of economic evaluations for the guide to community preventive services. Task force on community preventive services. Am J Prev Med. 2000;18(1 Suppl):15–71. Carande-Kulis VG, Maciosek MV, Briss PA, Teutsch SM, Zaza S, Truman BI, Messonnier ML, Pappaioanou M, Harris JR, Fielding J. Methods for systematic reviews of economic evaluations for the guide to community preventive services. Task force on community preventive services. Am J Prev Med. 2000;18(1 Suppl):15–71.
8.
go back to reference Burt BA. The changing patterns of systemic fluoride intake. J Dent Res. 1992;71(Spec Iss):1228–37.CrossRefPubMed Burt BA. The changing patterns of systemic fluoride intake. J Dent Res. 1992;71(Spec Iss):1228–37.CrossRefPubMed
9.
go back to reference Mariño R, Morgan M, Weitz A, Villa AE. Economic evaluation of the Codegua-Chile milk-fluoridation scheme. Community Dent Health. 2007;24:75–81.PubMed Mariño R, Morgan M, Weitz A, Villa AE. Economic evaluation of the Codegua-Chile milk-fluoridation scheme. Community Dent Health. 2007;24:75–81.PubMed
10.
go back to reference Mariño R, Fajardo J, Morgan M. Economic evaluation of dental caries prevention programs using milk and its products as the vehicle for fluorides: cost versus benefits. In: Watson R, Gerald J, Preedy V, editors. Dietary Supplements, and Nutriceuticals: Cost Analysis versus Clinical BenefitsPublisher: Springer (Humana Press); 2011. p. 143–61. Mariño R, Fajardo J, Morgan M. Economic evaluation of dental caries prevention programs using milk and its products as the vehicle for fluorides: cost versus benefits. In: Watson R, Gerald J, Preedy V, editors. Dietary Supplements, and Nutriceuticals: Cost Analysis versus Clinical BenefitsPublisher: Springer (Humana Press); 2011. p. 143–61.
11.
go back to reference Drummond MF, O’Brien B, Stoddart GL. Methods for the economic evaluation of health care programmes. New York: Oxford University Press; 1997. Drummond MF, O’Brien B, Stoddart GL. Methods for the economic evaluation of health care programmes. New York: Oxford University Press; 1997.
12.
go back to reference Barton P, Bryan S, Robinson S. Modelling in the economic evaluation of health care: selecting the appropriate approach. J Health Serv Res Policy. 2004;9:110–8.CrossRefPubMed Barton P, Bryan S, Robinson S. Modelling in the economic evaluation of health care: selecting the appropriate approach. J Health Serv Res Policy. 2004;9:110–8.CrossRefPubMed
13.
go back to reference Brennan A, Chick SE, Davies R. A taxonomy of model structures for economic evaluation of health technologies. Health Econ. 2006;15:1295–310.CrossRefPubMed Brennan A, Chick SE, Davies R. A taxonomy of model structures for economic evaluation of health technologies. Health Econ. 2006;15:1295–310.CrossRefPubMed
15.
go back to reference Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. For the panel on cost-effectiveness in health and medicine. The role of cost-effectiveness analysis in health and medicine. JAMA. 1996;276:1172–7.CrossRefPubMed Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. For the panel on cost-effectiveness in health and medicine. The role of cost-effectiveness analysis in health and medicine. JAMA. 1996;276:1172–7.CrossRefPubMed
16.
go back to reference Husereau D, Drummond M, Petrou S, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E. Consolidated health economic evaluation reporting standards (CHEERS)--explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines good reporting practices task force. Value Health. 2013;16(2):231–50.CrossRefPubMed Husereau D, Drummond M, Petrou S, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E. Consolidated health economic evaluation reporting standards (CHEERS)--explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines good reporting practices task force. Value Health. 2013;16(2):231–50.CrossRefPubMed
19.
go back to reference IndexMundi. Thailand Central bank discount rate. https://www.indexmundi.com/thailand/central_bank_discount_rate.html 2015. (accessed 09 Sept 2015). IndexMundi. Thailand Central bank discount rate. https://​www.​indexmundi.​com/​thailand/​central_​bank_​discount_​rate.​html 2015. (accessed 09 Sept 2015).
20.
go back to reference Gravelle H, Smith D. Discounting for health effects in cost-benefit and cost-effectiveness analysis. Health Econ. 2001;10:587–99.CrossRefPubMed Gravelle H, Smith D. Discounting for health effects in cost-benefit and cost-effectiveness analysis. Health Econ. 2001;10:587–99.CrossRefPubMed
21.
go back to reference Bureau of Dental Health. Department of Health, Ministry of Public Health (Thailand). Milk fluoridation Programme in Thailand. Annu Rep. 2010; Bureau of Dental Health. Department of Health, Ministry of Public Health (Thailand). Milk fluoridation Programme in Thailand. Annu Rep. 2010;
22.
go back to reference World Health Organization. Oral health surveys: basic methods. Geneva: World Health Organization; 1997. World Health Organization. Oral health surveys: basic methods. Geneva: World Health Organization; 1997.
24.
go back to reference World Health Organization. Prevention methods and programs for oral diseases. WHO Technical Report Series 713. Geneva: World Health Organization; 1984. World Health Organization. Prevention methods and programs for oral diseases. WHO Technical Report Series 713. Geneva: World Health Organization; 1984.
25.
go back to reference Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the United States. MMWR. 2001;50(RR14):1–42. Centers for Disease Control and Prevention. Recommendations for using fluoride to prevent and control dental caries in the United States. MMWR. 2001;50(RR14):1–42.
26.
go back to reference Niessen LC, Douglass C. Theoretical considerations in applying benefit-cost and cost-effectiveness analyses to preventive dental programs. J Public Health Dent. 1984;44:156–68.CrossRefPubMed Niessen LC, Douglass C. Theoretical considerations in applying benefit-cost and cost-effectiveness analyses to preventive dental programs. J Public Health Dent. 1984;44:156–68.CrossRefPubMed
Metadata
Title
Cost-effectiveness analysis of a school-based dental caries prevention program using fluoridated milk in Bangkok, Thailand
Authors
Rodrigo Mariño
Fernando Traub
Puangtong Lekfuangfu
Kornkamol Niyomsilp
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2018
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-018-0485-7

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