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Cost-effectiveness analysis of atraumatic restorative treatment to manage early childhood caries: microsimulation
U Tonmukayakul1, H Forrest2, P Arrow2
1Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
Background:
This study assessed the cost-effectiveness of atraumatic restorative treatment and the Hall Technique approach (ART/HT) in managing dental caries in young children under the health provider perspective in order to explore a best-buy alternative to dental general anaesthesia (DGA).
Methods:
Sixty-five observations from a randomized controlled trial were used to construct 20 000 microsimulations representing individual-level clinical outcome and costs of the DGA and ART/HT. Outcome was percentage of successfully managed cases. Costs were reported in 2020 price. Three different scenarios with different assumptions of clinical success of the DGA and the ART/HT were analysed. Probabilistic sensitivity analysis was carried out.
Results:
The ART/HT successfully managed more cases at lower cost ($557) than the DGA when the system failure of the DGA was considered. Under per protocol analysis, participants in both arms were successfully managed, but the ART/HT costed $580 less than the DGA. Probabilistic sensitivity analysis confirmed the ART/HT was a dominant intervention.
Conclusions:
The ART/HT approach was non-inferior in managing dental caries in young children but at lower costs than the DGA. The ART/HT could be a viable option in the provision of comprehensive dental care in locations with limited access to DGA and reduce hospital admission.
