Health economic potential of oral aMMP-8 biomarker diagnostics for personalised prevention of periodontal and peri-implant diseases

Objectives Active matrix metalloproteinase-8 (aMMP-8) biomarkers can be used in chair side tests for the detection of periodontitis or peri-implantitis and for targeting and monitoring individual therapy. Combined with effective secondary preventive measures, this procedure can reduce tooth loss and related costs. The authors evaluated whether out-of-pocket costs for the patient can be saved additionally. Methods A health economic evaluation of the total costs for secondary preventive versus prosthodontic measures was performed from the patient's perspective using a Markov-based state transition model with three health states of periodontitis. The intervention group used aMMP-8 biomarker diagnostics in addition to standard prevention services in Germany; the control group received standard care only. Starting age of the patients was 35 years; the modelled period was 50 years. Additionally, a first estimate of the costs for patients with implants for a period of three decades was made. Key findings In the first decade (age group 35-44 years), patients from the intervention group initially have to bear additional costs of 929.53 euro compared with the control group. From the age group 45-54 years, the savings potential for the patient increases continuously. Total costs of the intervention group, including additional aMMP-8 assessments, are 32 310.82 euro compared with 47 452.04 euro in the control group for the 50-year period. The greatest savings potential for patients with aMMP-8 screening and monitoring is in the field of dentures (-18.521.91 euro). For the subgroup of patients with implants, the first cost statement leads to costs of 12 672.66 euro with additional use of aMMP-8 biomarker diagnostics (control group: 23 185.83 euro). Conclusions Despite higher initial costs, secondary prevention not only improves oral health but also importantly can save significant costs in the long run. Especially in implant patients, need-based prevention can prolong the lifetime of dental implants and thus significantly save long-term treatment costs.