Patients’ Valuation of Fluoride Varnish in Brazil: using Willingness to Pay

Objectives: Decisions regarding resource allocation within a health care system, such as the Sistema Único de Saúde (SUS), can be aided by understanding patient preferences. Where patient preferences are used to inform decision making, the result can be a more patient centred system. Health economics has measures to allow systematic elicitation of preferences which can then be incorporated in economic evaluations to inform decision making so resources are used more efficiently. One such measures is Willingness to Pay (WTP) which values preferences in monetary terms. The aim of this study was therefore to ascertain the value of preventative dental care using fluoride varnish as an exemplar amongst citizens in Porto Alegre, Brazil using WTP.

Methods: A questionnaire eliciting willingness to pay for fluoride varnish alongside demographic and dental attitudinal data was administered to a consecutive sample of 100 patients aged 18 and over, using the SUS for their dental treatment. The setting was dental clinics at the Pontificial Catholic University of Rio Grande do Sul, Brazil

Results: Dental caries prevention, in the form of fluoride varnish, was valued by users of the SUS at a mean level of R$60.37 (=£15.17). There was significant variation within the sample with standard deviation of 63.44. Regression modelling revealed that higher income and infrequent visits to the dentist were significant positive influences on WTP. However, participant age, previous dental treatment and perceived need for future dental treatment did not appear to influence WTP.

Conclusions: WTP for fluoride varnish application in Brazil is highly variable, with significant influence from income and dental visit frequencies. This is an important finding for policy makers who may be able to use these findings to target caries preventive programmes better.