Chun June Sang, Har Alix, Lim Hyun-Pil, Lim Hoi-Jeong
School of Dentistry, Chonnam National University, Gwangju, Korea.
Northwestern University, USA.
J Adv Prosthodont. 2016 Feb;8(1):53-61. doi: 10.4047/jap.2016.8.1.53. Epub 2016 Feb 23.
This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective.
The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate.
When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment.
The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.
本研究从单一治疗角度对种植牙和传统固定义齿（CFDP）的成本效益进行分析。
对种植牙和CFDP进行成本效益分析的马尔可夫模型最长运行50年。通过10000次蒙特卡洛模拟进行概率敏感性分析，并给出成本效益可接受性曲线（CEAC）。荟萃分析研究的结果用于确定种植牙和CFDP的生存率及并发症发生率。从大学牙科医院和韩国统计局收集了2013年每种治疗方法的成本数据。利用患者满意度调查研究的结果，采用年度贴现率评估种植牙和CFDP策略的质量调整义齿年（QAPY）。
仅考虑直接成本时，治疗后第10年支付意愿（WTP）超过10000韩元时，种植牙更具成本效益，修复治疗后第20年起无论WTP如何，种植牙都更具成本效益。当间接成本加入直接成本后，仅在修复治疗后第10年WTP超过75000韩元、第20年超过35000韩元时，种植牙才更具成本效益。
除非修复治疗后第10年WTP超过75000韩元，否则CFDP更具成本效益。但随着时间推移，成本效益趋势从CFDP转变为种植牙。
