Cost-Utility Analysis of Treatments for Early Childhood Caries in Remote Aboriginal Communities
Date
2025
Authors
Tonmukayakul, U.
Kularatna, S.
Atkinson, D.
Jamieson, L.
Arrow, P.
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Advisors
Journal Title
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Volume Title
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Journal article
Citation
JDR Clinical and Translational Research, 2025; 1-9
Statement of Responsibility
U. Tonmukayakul, S. Kularatna, D. Atkinson, L. Jamieson, and P. Arrow
Conference Name
Abstract
Introduction: Early childhood caries is a significant problem affecting Aboriginal preschoolers in remote communities who lack access to dental services. A trial was conducted to assess the benefits of atraumatic restorative treatment combined with the Hall technique (ART-HT) versus usual care for managing early childhood caries in this population. Objectives: This trial-based costutility analysis evaluates costs and quality-adjusted life-years (QALYs) of ART-HT compared with usual care within a 1-y time frame. Methods: A decision-analytic model simulated the costs and QALYs for 2 scenarios: trial service delivery and minimum ART-HT delivery. The incremental cost per QALY gain ratio (ICER) was calculated for each scenario. QALY were estimated using the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) and adjusted for baseline. Probabilistic sensitivity analyses were conducted to assess the robustness of the base-case results. Cost-effectiveness acceptability curves were generated to determine the likelihood of ART-HT being costeffective at various willingness-to-pay thresholds. All costs are presented in Australian dollars for 2021. Results: Children receiving ART-HT had slightly higher QALYs than those receiving usual care did (0.85 vs. 0.83). The base-case analysis showed an average ICER of $2,013/ QALY gained (95% uncertainty interval −$45,246 to $21,676). In the sensitivity analysis, the average ICER was $2,573/QALY gained (95% uncertainty interval −$43,658 to $23,352). ART-HT had an 85% and 81% chance of being cost-effective at a $15,000/QALY gained threshold in the base-case and alternative scenario, respectively. Conclusion: ART-HT showed potential cost-effectiveness compared with usual care within the observed period. While QALY gains were modest, ART-HT may offer a valuable strategy to improve service access for Aboriginal children in remote communities.
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Dissertation Note
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OnlinePubl.
Available online 16 August 2025
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© International Association for Dental, Oral, and Craniofacial Research and American Association for Dental, Oral, and Craniofacial Research 2025