ABSTRACT
OBJECTIVE
To conduct a cost-effectiveness analysis of alternatives for rehabilitation treatment of mandibular edentulism in the context of the Brazilian Unified Health System (implant-supported total dental prosthesis versus conventional total dental prosthesis).
METHODS
A Markov model was developed to capture long-term clinical and economic outcomes. The model’s population was comprised of a hypothetical cohort of 1,000,000 patients, aged 55 years, with total mandibular edentulism and without medical contraindications for performing surgical procedures. The adopted analysis perspective was that of the Brazilian Unified Health System. Based on the proposed model, we calculated cost – in BRL, and effectiveness – measured by quality-adjusted prosthesis year (QAPY). The time horizon of the analysis was 20 years.
RESULTS
Considering a 5% discount in costs and effects, the incremental cost-effectiveness ratio of implant-supported total dental prostheses compared to conventional total dental prosthesis (BRL 464.22/QAPY) was lower than the willingness to pay threshold adopted in the model (BRL 3,050.00/QAPY).
CONCLUSIONS
The results of this economic analysis showed that the rehabilitation of mandibular edentulous patients by implant-supported total prosthesis is very cost-effective when compared to conventional complete prosthesis, considering the cost-effectiveness limits employed.
Jaw, Edentulous, rehabilitation; Dental Prosthesis, economics; Cost-Effectiveness Evaluation; Unified Health System
State B (repairable damages) contains:- in CTP: soft tissue complications, artificial tooth loss, need for implant reinsertion due to loss of retention and stability;- in ISTP: loss of the prosthetic connector, loss of artificial tooth, need for realignment.State C (treatment failure) contains:- in CTP: catastrophic fracture of the prosthesis, abandonment of the prosthesis;- in ISTP: implant loss.CTP: conventional total prosthesis; ISTP: implant-supported total prosthesis
QAPY: quality-adjusted prosthesis year
