Cost appraisal of a fluoride tablet programme to Manchester primary schoolchildren

The Manchester fluoride tablet trial was a pragmatic study to assist the Health Authority to decide whether to provide fluoride tablets daily to all primary schoolchildren in the District prior to water fluoridation being introduced. Twenty-two primary schools took part, half being allocated at random to the public health programme while the other half remained untreated. The average age at baseline was 5 yr 3 months. Costs were monitored throughout the trial and tangible and intangible benefits assessed. 263 children in the test schools and 266 in the control schools completed the trial. The cost per child was 4.39 pounds for the 3 yr of the trial. Economies resulting from an increase in size of a substantive scheme were estimated producing a cost of 1.98 pounds/child over a 3-yr period for a tangible benefit of 3.23 pounds. In addition, the intangible benefits of less anxiety, less treatment, and fewer experiences of general anaesthesia need consideration.