Microcosting and cost-effectiveness analysis for different devices used in endodontic therapy

Abstract

The objective was to compare the cost-effectiveness of different devices used in endodontic therapy, through micro-costing. A comparison was made between endodontic therapy techniques. The conventional technique, characterized by manual instrumentation and conventional odontometry (Mn+OC), and the techniques that incorporate: mechanized instrumentation (Mc+OC), electronic odontometry (Mn+OE), and both (Mc+OE). A panel of specialists (n=5) outlined the protocols for each technique, establishing clinical time, consumables, instruments, equipment and necessary human resources. The costs were extracted from the Price Panel of the Ministry of Management and Innovation in Public Services in Brazil. The value of each item was diluted according to frequency and time of use. Clinical hours for human resources were defined based on the national average salary for Endodontists and Oral Health Assistants. The sum of expenses with materials, equipment and human resources was obtained for each technique. An economic analysis was carried out using a decision tree to determine the cost-effectiveness of different techniques. It was found that Mc+OE had the shortest clinical time (1.12h), whereas Mn+OC had the longest (2.47h). Regarding costs, Mn+OC had the highest total cost (R$451.59) and the highest expenditure on human resources (R$ 402.81), Mc+OC resulted in the lowest total cost (R$ 330.93) and the technique Mc+OE the lowest expenditure on human resources (R$ 182.38). As for the incremental cost-effectiveness ratio, it was the lowest for Mc+OE (cost of R$ 66.53 per additional clinical hour), whereas Mn+OC was the highest (R$ 182.66/h). It is concluded that the incorporation of technologies to endodontic therapy is recommended in view of the better cost-effectiveness, when compared to the conventional technique.