Journal article
Economic Modeling of Sealing Primary Molars Using a “Value of Information” Approach
Journal of dental research, Vol.93(9), pp.876-881
09/01/2014
DOI: 10.1177/0022034514544299
PMCID: PMC4213251
PMID: 25056993
Abstract
The objective was to evaluate 2 primary molar sealant strategies for publicly insured children using an “expected value of perfect information” (EVPI) approach. We converted a 10,000-observation tooth-level cost-effectiveness simulation model comparing 2 primary molar sealant strategies – always seal (AS) and standard care (SC) – with a 1,250-observation child-level model. Costs
per
child
per
restoration or extraction averted were estimated. Opportunity losses under the AS strategy were determined for children for whom SC was the optimal choice. We determined the EVPI by multiplying mean opportunity losses by the projected incident population of publicly insured 3-year-olds in the US over 10 years with costs discounted at 2%. All analyses were conducted under assumptions of high and low intrachild correlations between at-risk teeth. The AS strategy cost $43.68 over SC (95% CI: −$5.50, $92.86)
per
child
per
restoration or extraction averted under the high intrachild correlation assumption and $15.54 (95% CI $7.86, $23.20) under the low intrachild correlation. Under high intrachild correlation, mean opportunity losses were $80.28 (95% CI: $76.39, $84.17)
per
child, and AS was the optimal strategy in 31% of children. Under low correlation, mean opportunity losses were $14.61 (95% CI: $12.20, $17.68) and AS was the optimal strategy in 87% of children. The EVPI was calculated at $530,813,740 and $96,578,389 (for high and low intrachild correlation, respectively), for a projected total incident population of 8,059,712 children. On average, always sealing primary molars is more effective than standard care, but widespread implementation of this preventive approach among publicly insured children would result in large opportunity losses. Additional research is needed to identify the subgroups of publicly insured children who would benefit the most from this effective and potentially cost-saving public health intervention.
Details
- Title: Subtitle
- Economic Modeling of Sealing Primary Molars Using a “Value of Information” Approach
- Creators
- J.P. Ney - University of WashingtonD.N. van der Goes - University of New MexicoD.L. Chi - University of Washington
- Resource Type
- Journal article
- Publication Details
- Journal of dental research, Vol.93(9), pp.876-881
- Publisher
- SAGE Publications
- DOI
- 10.1177/0022034514544299
- PMID
- 25056993
- PMCID
- PMC4213251
- ISSN
- 0022-0345
- eISSN
- 1544-0591
- Language
- English
- Date published
- 09/01/2014
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984283711202771
Metrics
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