European Journal of Orthodontics 35 (2013) 14–21

For many years there has been increasing emphasis on economic evaluation of health care interventions ( Elixhauser et al., 1993). Delivery of equitable health care in a cost-effective environment requires assessment of the economic implications of different interventions ( Kumar et al., 2006). With limited resources in the health sector (personnel, time, facilities, equipment, and expertise); failure to apply the principles of cost-effectiveness may bring an ‘ opportunity cost ’ , manifested as unsustainable nancial overexpenditure, or reduced services in other areas of health care (Drummond et al., 2005; Tickle, 1997). In future, economic evaluations are expected to assume increasing importance in the delivery of publicly funded orthodontic services: When allocating resources, health service planners will require evidence not only of the clinical effectiveness of treatment but also data disclosing ‘ value for money ’ ( Buck, 2000). Economic evaluation is de ned as ‘ the comparative analysis of alternative courses of action in terms of their costs and consequences ’ ( Drummond et al., 2005). Depending on the way in which the consequences are analyzed, four types of evaluations can be used to gather evidence and compare the expected costs and consequences of different procedures. A ‘ cost-effectiveness analysis ’ is characterized by analysis of both costs and outcomes, where the outcomes of alternative methods might differ in Early c orrection of p osterior c rossbite ಧ a c ost- m inimization analysi