Patient preferences for different tooth replacement strategies for the edentulous mandible: A Willingness-To-Pay analysis

Purpose: The aim of this study was to evaluate patients’ economic preferences for two different tooth replacement strategies for the edentulous mandible; conventional complete dentures (CCDs) and implant overdentures supported by two implants (IODs), using a willingness-to-pay (WTP) analysis. Methods: A sample of older patients (n=26) who had been rehabilitated with either a mandibular CCD or IOD were invited to participate in this study. All participants were provided with the details of the two treatment protocols including advantages, disadvantages and treatment costs. Then, patients were asked to indicate their maximum WTP values for each protocol using the payment card method for contingency evaluation. Results: Fifteen patients with a mandibular CCD (CCD-Group) and twelve patients with an IOD (IOD-Group) participated in the study. Overall, the median maximum WTP values recorded for IOD therapy was significantly higher than that for CCD therapy (p<0.05). Both treatment groups recorded maximum WTP values for CCD therapy which exceeded the market cost (¥30,000 (≓US$280)) [CCD-Group: ¥50,000 (IQR: 40,000 – 65,000), IOD-Group: ¥45,000 (IQR: 30,000 - 85,000)]. However, both groups indicated median maximum WTP values for IOD therapy lower than the market cost (¥780,000 (≓US$7,300)) [CCD-Group: ¥500,000 (IQR: 300,000 - 750,000), IOD-Group: ¥700,000 (IQR: 500,000 - 800,000)]. Conclusion: The maximum WTP values recorded for IOD therapy was significantly higher than CCD therapy in both treatment groups. Whilst patients were willing to pay more than then current market costs for CCDs, they were not willing to meet the market valuation for IODs.