Cost-effectiveness of fluoridation of Brisbane and South East Queensland drinking water supplies

Ciketic, Sadmir. (2007). Cost-effectiveness of fluoridation of Brisbane and South East Queensland drinking water supplies Master's Thesis, School of Economics, The University of Queensland.

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Author Ciketic, Sadmir.
Thesis Title Cost-effectiveness of fluoridation of Brisbane and South East Queensland drinking water supplies
School, Centre or Institute School of Economics
Institution The University of Queensland
Publication date 2007
Thesis type Master's Thesis
Total pages 92
Language eng
Subjects 14 Economics
Formatted abstract Objectives
The main aim of this study is to examine the effects and costs on dental health of population of implementing fluoridation of drinking water supplies for Brisbane and South East Queensland. Therefore it is examined whether it is cost-effective to fluoridate water supplies of South East Queensland that are currently not fluoridated. Many natural waters around the world contain fluorides in the level of around one part per million (1 ppm or alternatively 1 mg/litre). Fluoridation of water supplies is therefore only the adjustment of the fluoride concentration in those areas where it is significantly less than 0.2mg/l up to the level of 1mg/l. The benefits conveyed are expressed in reduced costs of dental treatment and years of life with dental caries as a disability.

The research paper reviews best available evidence on fluoridation of drinking water so far. Also economic evaluation techniques are explained in more details in order to understand the background of the analysis conducted. The analysis utilises a developed life table model in order to arrive at the results. The initial cohort consists of 36,322 newborns with 180,359 persons in the age group 2 to 100, 179,607 persons in the age group 7 to 100 and 179,411 persons in the age group 7 to 100. The costs of fluoridation intervention scenario consist of costs of fluoridation and costs of dental treatment. The fluoridation plant costs were assumed to occur every fifteen years as the fluoridation has an effective life of 15 years. The costs of non-fluoridated scenario consist of costs of dental treatment only. The analysis was conducted using a real discount rate of 3%. Sensitivity analyses investigated the effects of varying the parameters such as: discount rate, costs of dental treatment and costs of fluoridation plant. Uncertainty analysis was also conducted on costs and the measure of ratio of dmfs between cities of Brisbane (non-fluoridated) and Townsville (fluoridated).

It was found that fluoridation was extremely cost-effective, safe, efficient and equitable measure in the arena of public health for the population of South East Queensland and Brisbane in particular. If fluoridation was implemented there would be a total saving of 6086.5 (95% CI 4277.74-7808.37) disability-adjusted life years (DALYs) and AU$382,062,591 (95% CI -$520,000,000, $ 240,000,000). This result is both desirable and dominant as more DALYs are saved but and in fact saving costs as well.

Fluoridation remains still very cost-effective measure for reducing the dental decay and it should be implemented in Brisbane and South East Queensland as soon as possible. This measure will reduce the cost of treating dental caries drastically in the future and lower the disease burden associated with the disease of dental caries on population of Brisbane and South East Queensland.
Keyword Water -- Fluoridation -- Queensland, Southeastern.

Document type: Thesis
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