Is women’s vaccination against HPV in the Czech Republic cost-effective?
| Název práce v češtině: | Je očkování žen proti HPV v České republice nákladově efektivní? |
|---|---|
| Název v anglickém jazyce: | Is women’s vaccination against HPV in the Czech Republic cost-effective? |
| Klíčová slova: | Nákladová efektivita, Markův model, HPV, vakcinace, rakovina děložního čípku, ženy, Česká republika |
| Klíčová slova anglicky: | Cost-effectiveness, Markov model, HPV, vaccination, cervical carcinoma, women, Czech Republic |
| Akademický rok vypsání: | 2019/2020 |
| Typ práce: | bakalářská práce |
| Jazyk práce: | angličtina |
| Ústav: | Institut ekonomických studií (23-IES) |
| Vedoucí / školitel: | Mgr. Lenka Šlegerová |
| Řešitel: | skrytý - zadáno vedoucím/školitelem |
| Datum přihlášení: | 25.07.2020 |
| Datum zadání: | 25.07.2020 |
| Datum a čas obhajoby: | 07.09.2021 09:00 |
| Místo konání obhajoby: | Opletalova - Opletalova 26, O105, Opletalova - místn. č. 105 |
| Datum odevzdání elektronické podoby: | 27.07.2021 |
| Datum proběhlé obhajoby: | 07.09.2021 |
| Oponenti: | PhDr. Lucie Bryndová |
| Kontrola URKUND: | |
| Seznam odborné literatury |
| Damm, O., Horn, J., Mikolajczyk, R.T., Kretzschmar, M.E., Kaufmann, A.M., Deleré, Y., Ultsch, B., Wichmann, O., Krämer, A. and Greiner, W., 2017. Cost-effectiveness of human papillomavirus vaccination in Germany. Cost Effectiveness and Resource Allocation, 15(1), p.18.
Elbasha, E.H., Dasbach, E.J. and Insinga, R.P., 2007. Model for assessing human papillomavirus vaccination strategies. Emerging infectious diseases, 13(1), p.28. European Centre for Disease Prevention and Control., 2020. Guidance on HPV vaccination in EU countries: focus on boys, people living with HIV and 9-valent HPV vaccine introduction, Stockholm: ECDC. Gupta, N., Verma, R., Dhiman, R.K., Rajsekhar, K. and Prinja, S., 2019. Cost-Effectiveness Analysis and Decision Modelling: A Tutorial for Clinicians. Journal of Clinical and Experimental Hepatology. Usher, C., Tilson, L., Olsen, J., Jepsen, M., Walsh, C. and Barry, M., 2008. Cost-effectiveness of human papillomavirus vaccine in reducing the risk of cervical cancer in Ireland due to HPV types 16 and 18 using a transmission dynamic model. Vaccine, 26(44), pp.5654-5661. Westra, T.A., Rozenbaum, M.H., Rogoza, R.M., Nijman, H.W., Daemen, T., Postma, M.J. and Wilschut, J.C., 2011. Until which age should women be vaccinated against HPV infection? Recommendation based on cost-effectiveness analyses. Journal of Infectious Diseases, 204(3), pp.377-384. |
| Předběžná náplň práce v anglickém jazyce |
| Research question and motivation
In accordance with Act No. 48/1997 Coll., on Public Health Insurance, health insurance companies bear the cost of non-obligatory vaccination against human papillomavirus from thirteenth to fourteenth years of age of both girls and boys. My study will be oriented towards women. Westra, T.A. et al. (2011) suggest that vaccination has proven to be cost-effective for women up to the age of 25. However, there exists no catch-up programme in the Czech Republic that would provide vaccination at least at reduced costs for women above the set limit. European Centre for Disease Prevention and Control reports that catch-up programmes have been established, for example in France, the United Kingdom, the Netherlands and Lichtenstein. The main research question I am going to study is whether the current reimbursement setting of human papillomavirus vaccination in the Czech Republic is cost-effective compared to the designed situation where vaccination would be provided also for older women. The goal is to assess the cost-effectiveness of the existing situation in comparison with the designed change. If the research shows that the current situation could be improved, the aim is to suggest a policy change in vaccination in order to find reimbursement setting that would be more cost-effective and to reduce the future treatment costs of cervical and other types of cancer and diseases that HPV causes. Contribution The contribution of my thesis lies especially in its focus on the Czech Republic since as far as I know no such research has been published. Usher, C et al. (2008) conclude that implementing a catch-up programme for women up to 15 years of age would be the most cost-effective. However, my thesis shall examine the cost-effectiveness of implementation of catch-up programme also in older age groups. In addition, research conducted in Germany by Damm, O. et al. (2017) show that based on sensitivity analysis it is more cost-effective to vaccinate 16-year-old women compared to 12-year-old. (Limited 10-year protection was assumed.) My results could have a variety of implications in practice. Firstly, the existing policy in the Czech Republic could be adjusted according to the results in order to minimize the total costs incurred on vaccination and/or treatment of cervical cancer. Secondly, countries with a similar current policy (Slovakia, for example) could find usage of the research in implementing a similar change. Methodology Decision trees will be used to determine the overall effects of implementing the suggested change. The change in length and quality of patients’ life will be evaluated in terms of quality-adjusted life years (QALY) gained. QALY will be calculated using the health-related quality of life (HRQoL). Eventually, the final indicator – the incremented cost-effectiveness ratio (ICER) will be determined. The cost will be calculated by including the costs of carrying out the vaccination and its administration and the costs of treatment of potential disease. The above-mentioned methodology is in accordance with the one the State Institute for Drug Control recommends using for cost=effectiveness analyses. The analysis will be based on aggregate and average data consisting of mortality, incidence and the length of medical treatment of diseases caused by HPV, as well as on the current level of immunization and clinical effectivity of the vaccine. These data will be obtained from the Institute of Health Information and Statistics of the Czech Republic and health insurance companies. Another source of data will be the Cost Decree by The Ministry of Health of the Czech Republic. Outline Abstract Introduction HPV I. Human papillomavirus – classification II. Human papillomavirus in the Czech Republic and other countries III. HPV vaccination and treatment of diseases caused by HPV Data and Model I. Data description II. Decision tree model III. ICER computation Results I. Cost-effectiveness of evaluated policies II. Suggested policy change Conclusion I. Applications II. Topics for further research |