Skip to main content
Top
Published in: Health Economics Review 1/2019

Open Access 01-12-2019 | Care | Research

Willingness to pay for osteoporosis risk assessment in primary dental care

Authors: Helena Christell, Joanna Gullberg, Kenneth Nilsson, Sofia Heidari Olofsson, Christina Lindh, Thomas Davidson

Published in: Health Economics Review | Issue 1/2019

Login to get access

Abstract

Background

Fragility fracture related to osteoporosis among postmenopausal women is a significant cause of morbidity. The care and aftercare of these fractures are associated with substantial costs to society. A main problem is that many individuals suffer from osteoporosis without knowing it before a fracture happens. Dentists may have an important role in early identification of individuals with osteoporosis by assessment of dental radiographs already included in the dental examination. The aim of this study was therefore to investigate postmenopausal women’s preferences for an osteoporosis risk assessment in primary dental care.

Results

Most respondents (129 of 144 (90%)) were willing to pay for an osteoporosis risk assessment in primary dental care. The overall mean willingness to pay (WTP) including respondents that denoted none or zero WTP was 44.60 € (CI 95% 38.46–50.74 €) (median 34.75 €). A majority (80.6%) of the respondents that denoted WTP also gave a motivation for their answer. The two most common reasons denoted for being willing to pay for osteoporosis risk assessment were the importance of early diagnosis and preventive care to avoid fractures (41.0%) and the importance of knowledge of a risk of osteoporosis (26.4%). A majority of respondents (67.8%) considered it valuable if dental clinics would offer osteoporosis risk assessment.

Conclusions

Postmenopausal women seem to find it valuable to be offered osteoporosis risk assessment in primary dental care and are willing to pay for such a risk assessment. From a societal perspective early diagnosis of osteoporosis by risk assessment in primary dental care could prevent osteoporotic related fractures and benefit women’s health and quality of life, as well as have a major impact on the health-care budget in terms of cost-savings.
Literature
1.
go back to reference Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94:646–50. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94:646–50.
2.
go back to reference Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the international Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136.CrossRef Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the international Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8:136.CrossRef
3.
go back to reference Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jönsson B. Osteoporosis: burden, health care provision and opportunities in the EU. Osteoporosis: a report prepared in collaboration with the international Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2011;6:59–155.CrossRef Ström O, Borgström F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jönsson B. Osteoporosis: burden, health care provision and opportunities in the EU. Osteoporosis: a report prepared in collaboration with the international Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2011;6:59–155.CrossRef
4.
go back to reference WHO. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO study group. World Health Organ Tech Rep Ser. 1994;843:1–129. WHO. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO study group. World Health Organ Tech Rep Ser. 1994;843:1–129.
5.
go back to reference European Commission: Report on osteoporosis in the European Community. Strasbourg: European Community. 1998. European Commission: Report on osteoporosis in the European Community. Strasbourg: European Community. 1998.
6.
go back to reference Royal College of Physicians: Osteoporosis: clinical guidelines for the prevention and treatment. London: Royal College of Physicians. 1999. Royal College of Physicians: Osteoporosis: clinical guidelines for the prevention and treatment. London: Royal College of Physicians. 1999.
7.
go back to reference Horner K, Allen P, Graham J, Jacobs R, Boonen S, Pavitt S, Nackaerts O, Marjanovic E, Adams JE, Karayianni K, et al. The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:243–9.CrossRef Horner K, Allen P, Graham J, Jacobs R, Boonen S, Pavitt S, Nackaerts O, Marjanovic E, Adams JE, Karayianni K, et al. The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:243–9.CrossRef
9.
go back to reference Greenberg BL, Glick M, Frantsve-Hawley J, Kantor ML. Dentists' attitudes toward chairside screening for medical conditions. J Am Dent Assoc. 2010;141:52–62.CrossRef Greenberg BL, Glick M, Frantsve-Hawley J, Kantor ML. Dentists' attitudes toward chairside screening for medical conditions. J Am Dent Assoc. 2010;141:52–62.CrossRef
10.
go back to reference Laurence B. Dentists consider medical screening important and are willing to incorporate screening procedures into dental practice. J Evid Based Dent Pract. 2010;10:254–6.CrossRef Laurence B. Dentists consider medical screening important and are willing to incorporate screening procedures into dental practice. J Evid Based Dent Pract. 2010;10:254–6.CrossRef
11.
go back to reference Greenberg BL, Kantor ML, Jiang SS, Glick M. Patients' attitudes toward screening for medical conditions in a dental setting. J Public Health Dent. 2012;72:28–35.CrossRef Greenberg BL, Kantor ML, Jiang SS, Glick M. Patients' attitudes toward screening for medical conditions in a dental setting. J Public Health Dent. 2012;72:28–35.CrossRef
12.
go back to reference Creanor S, Millward BA, Demaine A, Price L, Smith W, Brown N, Creanor SL. Patients' attitudes towards screening for diabetes and other medical conditions in the dental setting. Br Dent J. 2014;216:E2.CrossRef Creanor S, Millward BA, Demaine A, Price L, Smith W, Brown N, Creanor SL. Patients' attitudes towards screening for diabetes and other medical conditions in the dental setting. Br Dent J. 2014;216:E2.CrossRef
13.
go back to reference Gullberg J, Axtelius B, Horner K, Devlin H, Lindh C, Poulsen L. Osteoporosis risk assessment in primary dental care - the attitudes of Swedish dentists, patients and medical specialists. Submitted to Gerodontology 2019. Gullberg J, Axtelius B, Horner K, Devlin H, Lindh C, Poulsen L. Osteoporosis risk assessment in primary dental care - the attitudes of Swedish dentists, patients and medical specialists. Submitted to Gerodontology 2019.
14.
go back to reference Heintz E, Gerber-Grote A, Ghabri S, Hamers FF, Rupel VP, Slabe-Erker R, Davidson T. EUnetHTA. Is there a european view on health economic evaluations? Results from a synopsis of methodological guidelines used in the EUnetHTA partner countries. Pharmacoeconomics. 2016;34:59–76.CrossRef Heintz E, Gerber-Grote A, Ghabri S, Hamers FF, Rupel VP, Slabe-Erker R, Davidson T. EUnetHTA. Is there a european view on health economic evaluations? Results from a synopsis of methodological guidelines used in the EUnetHTA partner countries. Pharmacoeconomics. 2016;34:59–76.CrossRef
15.
go back to reference Drummond M, Sculpher M, Torrance G, O'Brien B, Stoddard G. Methods for the economic evaluation of health care programmes. 4th ed. Oxford: Oxford University Press; 2015. Drummond M, Sculpher M, Torrance G, O'Brien B, Stoddard G. Methods for the economic evaluation of health care programmes. 4th ed. Oxford: Oxford University Press; 2015.
17.
go back to reference Oscarson N, Lindholm L, Källestål C. The value of caries preventive care among 19-year olds using the contingent valuation method within a cost-benefit approach. Community Dent Oral Epidemiol. 2007;35:109–17.CrossRef Oscarson N, Lindholm L, Källestål C. The value of caries preventive care among 19-year olds using the contingent valuation method within a cost-benefit approach. Community Dent Oral Epidemiol. 2007;35:109–17.CrossRef
18.
go back to reference Nayak S, Roberts MS, Greenspan SL. Osteoporosis screening preferences of older adults. J Clin Densitom. 2009;12:279–86.CrossRef Nayak S, Roberts MS, Greenspan SL. Osteoporosis screening preferences of older adults. J Clin Densitom. 2009;12:279–86.CrossRef
19.
go back to reference Lin PJ, Cangelosi MJ, Lee DW, Neumann PJ. Willingness to pay for diagnostic technologies: a review of the contingent valuation literature. Value Health. 2013;16:797–805.CrossRef Lin PJ, Cangelosi MJ, Lee DW, Neumann PJ. Willingness to pay for diagnostic technologies: a review of the contingent valuation literature. Value Health. 2013;16:797–805.CrossRef
20.
go back to reference Cunningham SJ, Hunt NP. Relationship between utility values and willingness to pay in patients undergoing orthognathic treatment community dent health, vol. 17; 2000. p. 92–6. Cunningham SJ, Hunt NP. Relationship between utility values and willingness to pay in patients undergoing orthognathic treatment community dent health, vol. 17; 2000. p. 92–6.
21.
go back to reference Birch S, Sohn W, Ismail AI, Lepkowski JM, Belli RF. Willingness to pay for dentin regeneration in a sample of dentate adults. Community Dent Oral Epidemiol. 2004;32:210–6.CrossRef Birch S, Sohn W, Ismail AI, Lepkowski JM, Belli RF. Willingness to pay for dentin regeneration in a sample of dentate adults. Community Dent Oral Epidemiol. 2004;32:210–6.CrossRef
22.
go back to reference van Steenberghe D, Bercy P, De Boever J, Adriaens P, Geers L, Hendrickx E, Adriaenssen C, Rompen E, Malmenäs M, Ramsberg J. Patient evaluation of a novel non-injectable anesthetic gel: a multicenter crossover study comparing the gel to infiltration anesthesia during scaling and root planing. J Periodontol. 2004;75:1471–8.CrossRef van Steenberghe D, Bercy P, De Boever J, Adriaens P, Geers L, Hendrickx E, Adriaenssen C, Rompen E, Malmenäs M, Ramsberg J. Patient evaluation of a novel non-injectable anesthetic gel: a multicenter crossover study comparing the gel to infiltration anesthesia during scaling and root planing. J Periodontol. 2004;75:1471–8.CrossRef
23.
go back to reference Esfandiari S, Lund JP, Penrod JR, Savard A, Thomason JM, Feine JS. Implant overdentures for edentulous elders: study of patient preference. Gerodontology. 2009;26:3–10.CrossRef Esfandiari S, Lund JP, Penrod JR, Savard A, Thomason JM, Feine JS. Implant overdentures for edentulous elders: study of patient preference. Gerodontology. 2009;26:3–10.CrossRef
24.
go back to reference Olsen JA, Smith RD. Theory versus practice: a review of 'willingness-to-pay' in health and health care. Health Econ. 2001;10:39–52.CrossRef Olsen JA, Smith RD. Theory versus practice: a review of 'willingness-to-pay' in health and health care. Health Econ. 2001;10:39–52.CrossRef
25.
go back to reference Whynes DK, Wolstenholme JL, Frew E. Evidence of range bias in contingent valuation payment scales. Health Econ. 2004;13:183–90.CrossRef Whynes DK, Wolstenholme JL, Frew E. Evidence of range bias in contingent valuation payment scales. Health Econ. 2004;13:183–90.CrossRef
26.
go back to reference Tan SHX, Vernazza CR, Nair R. Critical review of willingness to pay for clinical oral health interventions. J Dent. 2017;46:1–12.CrossRef Tan SHX, Vernazza CR, Nair R. Critical review of willingness to pay for clinical oral health interventions. J Dent. 2017;46:1–12.CrossRef
27.
go back to reference Donaldson C, Thomas R, Torgerson DJ. Validity of open-ended and payment scale approaches to eliciting willingness to pay. Appl Econ. 1997;29:79–84.CrossRef Donaldson C, Thomas R, Torgerson DJ. Validity of open-ended and payment scale approaches to eliciting willingness to pay. Appl Econ. 1997;29:79–84.CrossRef
28.
go back to reference Mobley LR, Hoerger TJ, Wittenborn JS, Galuska DA, Rao JK. Cost-effectiveness of osteoporosis screening and treatment with hormone replacement therapy, raloxifene, or alendronate. Med Decis Mak. 2006;26:194–206.CrossRef Mobley LR, Hoerger TJ, Wittenborn JS, Galuska DA, Rao JK. Cost-effectiveness of osteoporosis screening and treatment with hormone replacement therapy, raloxifene, or alendronate. Med Decis Mak. 2006;26:194–206.CrossRef
29.
go back to reference Nayak S, Roberts MS, Greenspan SL. Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women. Ann Intern Med. 2011;155:751–61.CrossRef Nayak S, Roberts MS, Greenspan SL. Cost-effectiveness of different screening strategies for osteoporosis in postmenopausal women. Ann Intern Med. 2011;155:751–61.CrossRef
Metadata
Title
Willingness to pay for osteoporosis risk assessment in primary dental care
Authors
Helena Christell
Joanna Gullberg
Kenneth Nilsson
Sofia Heidari Olofsson
Christina Lindh
Thomas Davidson
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
Health Economics Review / Issue 1/2019
Electronic ISSN: 2191-1991
DOI
https://doi.org/10.1186/s13561-019-0232-z

Other articles of this Issue 1/2019

Health Economics Review 1/2019 Go to the issue