Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia

Cobiac, Linda J. and Vos, Theo (2012) Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia. Community Dentistry and Oral Epidemiology, 40 4: 369-376. doi:10.1111/j.1600-0528.2012.00684.x


Author Cobiac, Linda J.
Vos, Theo
Title Cost-effectiveness of extending the coverage of water supply fluoridation for the prevention of dental caries in Australia
Journal name Community Dentistry and Oral Epidemiology   Check publisher's open access policy
ISSN 0301-5661
1600-0528
Publication date 2012-08
Sub-type Article (original research)
DOI 10.1111/j.1600-0528.2012.00684.x
Volume 40
Issue 4
Start page 369
End page 376
Total pages 8
Place of publication Malden, MA United States
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
Objective: Fluoride was first added to the Australian water supply in 1953, and by 2003, 69% of Australia's population was receiving the minimum recommended dose. Extending coverage of fluoridation to all remaining communities of at least 1000 people is a key strategy of Australia's National Oral Health Plan 2004-2013. We evaluate the cost-effectiveness of this strategy from an Australian health sector perspective.
Methods: Health gains from the prevention of caries in the Australian population are modelled over the average 15-year lifespan of a treatment plant. Taking capital and on-going operational costs of fluoridation into account, as well as costs of caries treatment, we determine the dollars per disability-adjusted life years (DALY) averted from extending coverage of fluoridation to all large (≥1000 people) and small (<1000 people) communities in Australia.
Results:
Extending coverage of fluoridation to all communities of at least 1000 people will lead to improved population health (3700 DALYs, 95% uncertainty interval: 2200-5700 DALYs), with a dominant cost-effectiveness ratio and 100% probability of cost-savings. Extending coverage to smaller communities leads to 60% more health gains, but is not cost-effective, with a median cost-effectiveness ratio of A$92 000/DALY and only 10% probability of being under a cost-effectiveness threshold of A$50 000/DALY.
Conclusions:
Extension of fluoridation coverage under the National Oral Health Plan is highly recommended, but given the substantial dental health disparities and inequalities in access to dental care that currently exist for more regional and remote communities, there may be good justification for extending coverage to include all Australians, regardless of where they live, despite less favourable cost-effectiveness.
Keyword Cost effectiveness
Dental caries
Economics
Fluoridation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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