A critique of recent economic evaluations of community water fluoridation
Identifieur interne : 001079 ( Pmc/Checkpoint ); précédent : 001078; suivant : 001080A critique of recent economic evaluations of community water fluoridation
Auteurs : Lee Ko [États-Unis] ; Kathleen M. ThiessenSource :
- International Journal of Occupational and Environmental Health [ 1077-3525 ] ; 2015.
Abstract
Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.
To examine the reported cost-effectiveness of CWF.
Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.
Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.
Url:
DOI: 10.1179/2049396714Y.0000000093
PubMed: 25471729
PubMed Central: 4457131
Affiliations:
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<author><name sortKey="Ko, Lee" sort="Ko, Lee" uniqKey="Ko L" first="Lee" last="Ko">Lee Ko</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A critique of recent economic evaluations of community water fluoridation</title>
<author><name sortKey="Ko, Lee" sort="Ko, Lee" uniqKey="Ko L" first="Lee" last="Ko">Lee Ko</name>
<affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Oakland, CA, USA</addr-line>
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<placeName><region type="state">Californie</region>
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<author><name sortKey="Thiessen, Kathleen M" sort="Thiessen, Kathleen M" uniqKey="Thiessen K" first="Kathleen M" last="Thiessen">Kathleen M. Thiessen</name>
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<series><title level="j">International Journal of Occupational and Environmental Health</title>
<idno type="ISSN">1077-3525</idno>
<idno type="eISSN">2049-3967</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background:</title>
<p>Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.</p>
</sec>
<sec><title>Objective:</title>
<p>To examine the reported cost-effectiveness of CWF.</p>
</sec>
<sec><title>Methods:</title>
<p>Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.</p>
</sec>
<sec><title>Results:</title>
<p>Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.</p>
<p><bold>Conclusions:</bold>
Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.</p>
</sec>
</div>
</front>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Occup Environ Health</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Occup Environ Health</journal-id>
<journal-id journal-id-type="publisher-id">OEH</journal-id>
<journal-title-group><journal-title>International Journal of Occupational and Environmental Health</journal-title>
</journal-title-group>
<issn pub-type="ppub">1077-3525</issn>
<issn pub-type="epub">2049-3967</issn>
<publisher><publisher-name>Maney Publishing</publisher-name>
<publisher-loc>Suite 1C, Joseph's Well, Hanover Walk, Leeds LS3 1AB, UK</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25471729</article-id>
<article-id pub-id-type="pmc">4457131</article-id>
<article-id pub-id-type="publisher-id">oeh-21-91</article-id>
<article-id pub-id-type="doi">10.1179/2049396714Y.0000000093</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>A critique of recent economic evaluations of community water fluoridation</article-title>
<alt-title alt-title-type="running-head">Economic evaluations CWF</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Ko</surname>
<given-names>Lee</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Thiessen</surname>
<given-names>Kathleen M</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff1"><label>1</label>
<addr-line>Oakland, CA, USA</addr-line>
</aff>
<aff id="aff2"><label>2</label>
<addr-line>Oak Ridge Center for Risk Analysis, Oak Ridge, TN, USA</addr-line>
</aff>
<author-notes><corresp>Correspondence to: Kathleen M. Thiessen, Oak Ridge Center for Risk Analysis, 102 Donner Drive, Oak Ridge, TN 37830, USA. Email: <email xlink:href="kmt@orrisk.com">kmt@orrisk.com</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>3</month>
<year>2015</year>
</pub-date>
<volume>21</volume>
<issue>2</issue>
<fpage>91</fpage>
<lpage>120</lpage>
<permissions><copyright-statement>© W. S. Maney & Son Ltd 2015</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Maney Publishing</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>MORE OpenChoice articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial License 3.0</license-p>
</license>
</permissions>
<abstract><sec><title>Background:</title>
<p>Although community water fluoridation (CWF) results in a range of potential contaminant exposures, little attention has been given to many of the possible impacts. A central argument for CWF is its cost-effectiveness. The U.S. Government states that $1 spent on CWF saves $38 in dental treatment costs.</p>
</sec>
<sec><title>Objective:</title>
<p>To examine the reported cost-effectiveness of CWF.</p>
</sec>
<sec><title>Methods:</title>
<p>Methods and underlying data from the primary U.S. economic evaluation of CWF are analyzed and corrected calculations are described. Other recent economic evaluations are also examined.</p>
</sec>
<sec><title>Results:</title>
<p>Recent economic evaluations of CWF contain defective estimations of both costs and benefits. Incorrect handling of dental treatment costs and flawed estimates of effectiveness lead to overestimated benefits. The real-world costs to water treatment plants and communities are not reflected.</p>
<p><bold>Conclusions:</bold>
Minimal correction reduced the savings to $3 per person per year (PPPY) for a best-case scenario, but this savings is eliminated by the estimated cost of treating dental fluorosis.</p>
</sec>
</abstract>
<kwd-group><kwd>Water fluoridation</kwd>
<kwd>Economic evaluation</kwd>
<kwd>Cost of water fluoridation</kwd>
<kwd>Caries prevention</kwd>
<kwd>Cost benefit</kwd>
<kwd>Cost effectiveness</kwd>
<kwd>Effectiveness in adults</kwd>
<kwd>Dental fluorosis</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
</region>
</list>
<tree><noCountry><name sortKey="Thiessen, Kathleen M" sort="Thiessen, Kathleen M" uniqKey="Thiessen K" first="Kathleen M" last="Thiessen">Kathleen M. Thiessen</name>
</noCountry>
<country name="États-Unis"><region name="Californie"><name sortKey="Ko, Lee" sort="Ko, Lee" uniqKey="Ko L" first="Lee" last="Ko">Lee Ko</name>
</region>
</country>
</tree>
</affiliations>
</record>
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