A cost–utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony

Introduction: Management of dentofacial discrepancies using orthognathic treatment is now a common procedure in the United Kingdom. Although the benefits of orthognathic intervention are often considered, the cost implications have not been investigated to our knowledge. This study is a cost–utility analysis of orthognathic treatment. Patients and methods: Twenty-one patients were interviewed five times during treatment using the time trade-off (TTO) method to establish utility values. Quality adjusted life years (QALYs) gained as a result of treatment were calculated and discounted. The resource use was calculated for each of the 21 patients individually and the costs subjected to both a sensitivity analysis and discounting. The incremental mean cost per additional QALY was calculated (as compared with a ‘no treatment’ approach). Results: The incremental cost for each additional QALY was £561 for the groups combined, based on mean additional costs and QALYs (£546 for the bimaxillary group and £617 for the single jaw group). Discussion: Orthognathic treatment seems to provide good outcomes at relatively low cost. Even allowing for the uncertainty in mean costs and QALYs, there is a high probability of treatment being cost-effective. Cost–utility analysis is still a relatively new technique in dentistry and further studies should be encouraged.