Modeling an economic evaluation of a salt fluoridation program in Peru


  • This study was funded by a grant received from International Association for Dental Research, Regional Development program.

Dr. Rodrigo Mariño, PhD, Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, VIC 3010, Australia. Tel.: +61-3-9341-1558;Fax: +61-3-9341-1597; e-mail: Rodrigo J. Mariño and Jorge Fajardo are with the Cooperative Research Centre for Oral Health Science, University of Melbourne. Ana Arana, Carlos Garcia, and Flor Pachas are with the Facultad de Estomatología, Universidad Peruana Cayetano Heredia.


Objective: This article models the cost-effectiveness, from a societal viewpoint, of a dental caries prevention program using salt fluoridation for children 12 years of age, compared with non-intervention (or status quo) in Arequipa, Peru.

Methods: Standard cost-effectiveness analysis methods were used. The costs associated with implementing and operating the salt-fluoridation program were identified and measured using 2009 prices. Health outcomes were measured as dental caries averted over a 6-year period. Clinical effectiveness data was taken from published data. Costs were measured as direct treatment costs, programs costs and costs of productivity losses as a result of dental treatments. The incremental cost-effectiveness ratio was calculated. A hypothetical population of 25,000 12-year-olds living in Arequipa, Peru was used in this analysis. Two-way sensitivity analyses were conducted over a range of values for key parameters.

Results: Our primary analysis estimated that if a dental caries prevention program using salt-fluoridation was available for 25,000 6-year-old children for 6 years, the net saving from a societal perspective would total S/. 11.95 [1 US$ = S/. (2009) 3.01] per diseased tooth averted when compared with the status quo group. That is, after 6 years, an investment of S/.0.32 per annum per child would result in a net saving of S/.11.95 per decayed/missing/filled teeth prevented.

Conclusions: While the analysis has inherent limitations as a result of its reliance on a range of assumptions, the findings indicate that for the situations prevailing in Peru, there are significant health and economic benefits to be gained from the use of salt fluoridation.