An exploratory study of the cost-effectiveness of orthodontic care in seven European countries

This study investigated the orthodontic treatment of 429 consecutive patients [172 male (40.1 per cent) and 257 female (59.9 per cent)] carried out by 10 orthodontic specialist practitioners in seven European countries [two in the Czech Republic (A and B), two in Germany (A and B), Italy, Latvia, Lithuania, and Netherlands, and two in Slovenia (A and B)]. The median age of the patients at the start of treatment was 13.0 years (minimum 7.3 years maximum 50.3 years). The patients had a range of malocclusions and the majority (97 per cent) were treated with upper and lower fixed appliances.Real exchange rates were calculated using purchasing power parity (PPP) indicators to allow cross-border comparisons of costs. The Index of Complexity, Outcome and Need (ICON) was used to measure the effectiveness of treatment and cost per ICON point reduction to compare cost-effectiveness of orthodontic treatment between practitioners in different European countries. The median cost per ICON point reduction for all the cases treated was €57.69. The median cost per ICON point reduction varied greatly between practitioners from €21.70 (Lithuania) to €116.62 (Slovenia A). Analysis of variance and Tukey post hoc tests showed the differences in cost-effectiveness between the practitioners to be statistically significant (P < 0.001). The cost per ICON point reduction is a simple and effective method of comparing cost-effectiveness between orthodontic practitioners in different countries