title: THE CARIES MANAGEMENT SYSTEM: UPDATING COST-EFFECTIVENESS WITH 4-YEAR POSTTRIAL DATA.
abstract: OBJECTIVE
  Long-term follow-up of the Caries Management System (CMS) protocol demonstrated that regular monitoring and noninvasive management of dental caries is effective in reducing the number of caries-related events over a 7-year period. This analysis complements the authors' original economic evaluation of the CMS by re-evaluating the per-protocol cost-effectiveness of the CMS approach.
  
  
  METHODS
  An individual patient-simulation Markov model was developed previously, based on 3-year randomized-controlled trial (RCT) data, to simulate the incidence and progression of dental caries, and resultant interventions, and to evaluate the lifetime cost-effectiveness of the CMS versus standard dental care from the Australian private dental practitioner perspective (in which the baseline age distribution was similar to that of the Australian population). The 4-year posttrial follow-up data are used to re-evaluate the long-term cost-effectiveness of the CMS in a more real-life setting.
  
  
  RESULTS
  The reduction in caries risk was maintained among those practices within which the CMS protocols were adhered to. The per-protocol model appears to be reasonably accurate at predicting the risk of restorative events in the posttrial follow-up period. The per-protocol lifetime cost per restorative event avoided is AUD1,980 (USD1,409; 1 AUD = 0.71 USD).
  
  
  CONCLUSIONS
  The current analysis confirms that the CMS approach is both effective, when the protocols are adhered to appropriately, and cost-effective compared with standard care in the Australian private practice setting.
authors: HERA Consulting Australia Pty Ltdemma@heraconsulting.com.au.
authors: Emma
authors: E
authors: Warren
authors: Eli Lily and Company.
authors: Bradley H
authors: BH
authors: Curtis
authors: Eli Lily and Company.
authors: Nan
authors: N
authors: Jia
authors: Faculty of Dentistry,University of Sydney.
authors: R Wendell
authors: RW
authors: Evans
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D003731:Dental Caries / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D008390:Markov Chains; D008875:Middle Aged; D009909:Oral Health / Q000191:economics*; D016032:Randomized Controlled Trials as Topic
keywords: Cost-effectiveness; Dental caries; Economic analysis; Markov process; Prevention