Economist report on socio-economic impact of periodontitis. Germany: how eliminating gingivitis is most cost-effective strategy

In Germany, a public-health strategy based on eliminating of gingivitis (and thus preventing progression to periodontitis) would almost halve the costs involved in a “business as usual” approach, according to the recent report on the financial and human cost of periodontitis, commissioned by the EFP and published by the Economist Intelligence Unit (EIU).

The report, Time to take gum disease seriously: The societal and economic impact of periodontitis, shows that the “baseline” costs – the “business as usual”  scenario – amount to €20.9 billion over a ten-year period, which equates to €35 per “healthy life year”.

If eliminating gingivitis – the scenario which the report clearly shows to be the most cost-effective – were adopted, costs would fall to just over €11.8 billion, representing €19 per healthy life year, a gain of 5.7 million healthy life years among the German population, and a substantial return-on-investment (ROI) – the ratio between gains and costs – of 57.5.

Managing only 10% of gingivitis cases would involve slightly lower costs than the baseline scenario – €21.4 billion (€42 per healthy life year). But it would have the effect of reducing the number of healthy life years by 5.7 million and would result in a negative ROI of 1007.

The scenario of a 90% periodontitis diagnosis rate with all diagnosed cases managed would increase costs massively – to €66.4 billion (€104 per healthy life year). But in terms of the increased number of healthy life years, the result would be inferior to the eliminating-gingivitis scenario (5.1 million compared to 5.7 million) and the ROI would be much smaller – 10.4.

In terms of the healthcare model deployed in Germany, the report notes that almost 90% of the German population belongs to one of the long-established, insurance-based, not-for-profit “sick funds”, which provide a legally prescribed standard package of healthcare that includes all medically necessary conservative and surgical dental treatment. Private dental insurance is also widely used.

Attracting attention

Bettina Dannewitz, president of the German Society of Periodontology (DG PARO) welcomed the report and said that it was the first time that economists had stated that periodontal prevention saves costs and that “this may attract the attention of politicians.”

Prof Dannewitz added that the situation in Germany had improved recently, as a new directive of periodontal treatment covered by statutory health insurance came into effect on July 1 and allows patients to receive periodontal treatment mostly in line with the EFP’s clinical practice guideline. However, she noted, “the treatment of gingivitis in adults is still not covered.”

DG Paro is preparing an initiative to promote dental awareness, with a particular focus on periodontal disease, in collaboration with the German Dental Chamber (BSÄK). It is also likely to use the information from the EIU report in its annual meeting at the German parliament with spokespeople on health policy.

READ EIU REPORT