A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony.
BACKGROUND
Management of dentofacial discrepancies using orthognathic treatment is now a common procedure in the United Kingdom. Although the benefits of orthognathic intervention are often considered, the cost implications have not been investigated to our knowledge. This study is a cost-utility analysis of orthognathic treatment.


METHODS
Twenty-one patients were interviewed five times during treatment using the time trade-off (TTO) method to establish utility values. Quality adjusted life years (QALYs) gained as a result of treatment were calculated and discounted. The resource use was calculated for each of the 21 patients individually and the costs subjected to both a sensitivity analysis and discounting. The incremental mean cost per additional QALY was calculated (as compared with a 'no treatment' approach).


RESULTS
The incremental cost for each additional QALY was 561 pounds sterling for the groups combined, based on mean additional costs and QALYs (546 pounds sterling for the bimaxillary group and 617 pounds sterling for the single jaw group).


CONCLUSIONS
Orthognathic treatment seems to provide good outcomes at relatively low cost. Even allowing for the uncertainty in mean costs and QALYs, there is a high probability of treatment being cost-effective. Cost-utility analysis is still a relatively new technique in dentistry and further studies should be encouraged.
Cunningham
S J
SJ
Department of Orthodontics, Eastman Dental Institute for Oral Health Care Sciences, University College London, London, UK. s.cunningham@eastman.ucl.ac.uk
Sculpher
M
M
Sassi
F
F
Manca
A
A
D000328:Adult; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000191:economics*; D019057:Quality-Adjusted Life Years; D006113:United Kingdom