{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:49:11Z","timestamp":1787071751316,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Oral submucous fibrosis (OSF) is a chronic, progressive disorder characterised by reduced mouth opening (MO) and a risk of malignant transformation. Despite numerous non-surgical interventions, sustained functional improvement remains elusive. This study introduces a cost-effectiveness analysis framework to compare various OSF treatments, addressing a critical knowledge gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Data from a previously published network meta-analysis (NMA) comprising 72 studies (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 5268 patients) were analysed. Cost\/millimeter of MO improvement (cost\/mm) and cost\/millimeter\/week (cost\/mm\/week) were calculated. Incremental Cost-Effectiveness Ratio (ICER) was computed against placebo and multivitamins.\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u22640.05 considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The median cost\/mm was INR 1906.57, ranging from INR 403.35 (ultrasound + exercise) to INR 10,368.36 (steroids + exercise). Cost\/mm\/week ranged from INR 59.97 (topical steroids) to INR 2292.83 (steroids + exercise). Kruskal\u2013Wallis tests showed significant differences in cost\/mm (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002) and cost\/mm\/week (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004). ICER analysis identified steroid with or with spreading factor (SSF) + exercise as the most cost-effective (\u20134918.38 INR\/placebo, \u20132365.78 INR\/multivitamins), while SSF + placebo was least cost-effective (ICER: 8540.79 INR\/placebo, 8382.25 INR\/multivitamins).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusion:<\/jats:title>\n                    <jats:p>This study presents the first cost-effectiveness analysis of non-surgical OSF treatments, revealing substantial economic variations across interventions. Ultrasound with exercise and SSF + exercise was the most cost-efficient, supporting the integration of multimodal non-pharmacological therapies into OSF management. Conversely, nutraceutical products (NPs) demonstrated inconsistent cost-effectiveness, with systemic NPs outperforming topical applications. Given the economic burden and limited efficacy of some treatments, these findings emphasise the need for evidence-based, cost-conscious decision-making. The cost\/mm and cost\/mm\/week metrics provide a novel perspective, facilitating better resource allocation in OSF care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijdr.ijdr_222_25","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T16:00:34Z","timestamp":1763395234000},"page":"471-478","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness Analysis of Non-Surgical Interventions for Oral Submucous Fibrosis: A Novel Economic Framework"],"prefix":"10.4103","volume":"36","author":[{"given":"Anusa Arunachalam","family":"Mohandoss","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Shree Satya Sai Medical College and Research Institute, Affiliated to Sri Balaji Vidyapeeth, Deemed to be University, Chennai, Tamil Nadu, 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