We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Impact of Treating Oral Disease on Preventing Vascular Diseases: A Model-Based Cost-effectiveness Analysis of Periodontal Treatment Among Patients With Type 2 Diabetes.
- Authors
Sung Eun Choi; Sima, Corneliu; Pandya, Ankur; Choi, Sung Eun
- Abstract
<bold>Objective: </bold>Previous randomized trials found that treating periodontitis improved glycemic control in patients with type 2 diabetes (T2D), thus lowering the risks of developing T2D-related microvascular diseases and cardiovascular disease (CVD). Some payers in the U.S. have started covering nonsurgical periodontal treatment for those with chronic conditions, such as diabetes. We sought to identify the cost-effectiveness of expanding periodontal treatment coverage among patients with T2D.<bold>Research Design and Methods: </bold>A cost-effectiveness analysis was conducted to estimate lifetime costs and health gains using a stochastic microsimulation model of oral health conditions, T2D, T2D-related microvascular diseases, and CVD of the U.S.<bold>Population: </bold>Model parameters were obtained from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2009-2014) and randomized trials of periodontal treatment among patients with T2D.<bold>Results: </bold>Expanding periodontal treatment coverage among patients with T2D and periodontitis would be expected to avert tooth loss by 34.1% (95% CI -39.9, -26.5) and microvascular diseases by 20.5% (95% CI -31.2, -9.1), 17.7% (95% CI -32.7, -4.7), and 18.4% (95% CI -34.5, -3.5) for nephropathy, neuropathy, and retinopathy, respectively. Providing periodontal treatment to the target population would be cost saving from a health care perspective at a total net savings of $5,904 (95% CI -6,039, -5,769) with an estimated gain of 0.6 quality-adjusted life years per capita (95% CI 0.5, 0.6).<bold>Conclusions: </bold>Providing nonsurgical periodontal treatment to patients with T2D and periodontitis would be expected to significantly reduce tooth loss and T2D-related microvascular diseases via improved glycemic control. Encouraging patients with T2D and poor oral health conditions to receive periodontal treatment would improve health outcomes and still be cost saving or cost-effective.
- Subjects
UNITED States; TOOTH loss; TYPE 2 diabetes; ORAL diseases; VASCULAR diseases; HEALTH &; Nutrition Examination Survey; QUALITY-adjusted life years; PERIODONTITIS treatment; CARDIOVASCULAR disease prevention; COMPUTER simulation; RESEARCH; CLINICAL trials; PERIODONTITIS; RESEARCH methodology; CARDIOVASCULAR diseases; EVALUATION research; MEDICAL cooperation; SURVEYS; PREVENTIVE health services; COMPARATIVE studies; COST effectiveness; STATISTICAL models; DIABETIC angiopathies; DISEASE complications
- Publication
Diabetes Care, 2020, Vol 43, Issue 3, p563
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc19-1201