Cost effectiveness analysis of missing teeth prosthetic treatment for edentulous mandibular ridge using the Markov model and Monte-Carlo simulation

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K17159
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Prosthodontics/ Dental materials science and
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Komagamine Yuriko 東京医科歯科大学, 大学院医歯学総合研究科, 助教 (50613692)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 費用対効果

Outline of Final Research Achievements

In this report, the Markov model for cost-effectiveness analysis was carried out over maximum 15 years to analyze treatments of cost-effectiveness of one-unsplinted-implant-supported overdentures retained by ball attachments (1IOD), two-unsplinted-implant-supported overdentures retained by ball attachments (2IOD) and conventional complete dentures (CD) among patients who have edentulous mandibular redge. As the results, CD was most cost-effective treatment among all of three treatments when the willingness to pay (WTP) was less than 2,524 yen 10 years later after the treatment. 1IOD was most cost-effective treatment when WTP was more than 2,525 yen and less than 8,361 yen 15 years later after the treatment. 2IOD was most cost-effective treatment when WTP was more than 8,362 yen. In the future study, we should carry out meta-analysis, obtain transition probably rates and treatment effectiveness index from the meta-analysis, and conduct cost-effectiveness analysis using more big data.

Free Research Field

補綴学分野

Academic Significance and Societal Importance of the Research Achievements

日本における医療政策では医療経済評価は頻繁に活用されていなかったが，2016年4月以降，費用対効果評価が試行的に導入されることとなった．医療経済評価は医療費の削減や，患者の利益の向上，医療分野の研究開発の促進につながり，歯科医療分野でも同様であると思われる．補綴歯科分野においても高度かつ高額な治療方法が増加しているため，費用対効果分析を行うことで，限られた資源の中でより効率的に患者利益を得られる治療方法を探索することが可能となる．今回の研究によって無歯顎者の費用対効果の高い治療法が明らかになることは，医療費の削減だけでなく，費用対効果分析の歯科医療分野における実用性が明らかになる．