Health technology assessment od digital diabetes therapeutics
| Název práce v češtině: | Hodnocení zdravotnických technologií: digitální aplikace pro diabetiky |
|---|---|
| Název v anglickém jazyce: | Health technology assessment od digital diabetes therapeutics |
| Klíčová slova: | Hodnocení zdravotnických technologií (HTA), Cukrovka 2. typu, Analýza nákladové efektivity, Mobilní zdravotnictví, Markovův model |
| Klíčová slova anglicky: | Health technology assessment (HTA), Type 2 diabetes, Cost-effectiveness analysis, mHealth, Markov model |
| Akademický rok vypsání: | 2020/2021 |
| Typ práce: | diplomová práce |
| Jazyk práce: | angličtina |
| Ústav: | Institut ekonomických studií (23-IES) |
| Vedoucí / školitel: | PhDr. Mgr. Jana Votápková, Ph.D. |
| Řešitel: | skrytý - zadáno vedoucím/školitelem |
| Datum přihlášení: | 11.06.2021 |
| Datum zadání: | 11.06.2021 |
| Datum a čas obhajoby: | 15.06.2022 09:00 |
| Místo konání obhajoby: | Opletalova - Opletalova 26, O314, Opletalova - místn. č. 314 |
| Datum odevzdání elektronické podoby: | 01.05.2022 |
| Datum proběhlé obhajoby: | 15.06.2022 |
| Oponenti: | doc. Paola Bertoli, M.A., M.Sc., D.Phil. |
| Kontrola URKUND: | |
| Seznam odborné literatury |
| Agnihothri, Saligrama, et al. "The value of mHealth for managing chronic conditions." Health care management science 23.2 (2020): 185-202.
Briggs, Andrew, and Mark Sculpher. "An introduction to Markov modelling for economic evaluation." Pharmacoeconomics 13.4 (1998): 397-409. Briggs, Andrew, Mark Sculpher, and Martin Buxton. "Uncertainty in the economic evaluation of health care technologies: the role of sensitivity analysis." Health economics 3.2 (1994): 95-104. Drummond, Michael F., et al. Methods for the economic evaluation of health care programmes. Oxford university press, 2015. Goodman, Clifford S. "Introduction to health technology assessment." The Lewin Group. virginia, USA (2004). Rinaldi, Giulia, Alexa Hijazi, and Hassan Haghparast-Bidgoli. "Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: A systematic review." Diabetes research and clinical practice 162 (2020): 108084. Timpel, Patrick, et al. "Mapping the evidence on the effectiveness of telemedicine interventions in diabetes, dyslipidemia, and hypertension: an umbrella review of systematic reviews and meta-analyses." Journal of medical Internet research 22.3 (2020): e16791. World Health Organization. Global Report on Diabetes. 1st ed., World Health Organization, 2016. |
| Předběžná náplň práce |
| Research question and motivation
Diabetes mellitus is a chronic disease characterized by the elevated levels of blood glucose. As the disease progresses, it might lead to serious damage to the heart, blood vessels, eyes, kidneys and nerves (WHO, 2016). In recent decades, the prevalence is rising in all countries, regardless of the income level. In Europe alone, 60 million people over 20 years of age are diagnosed with diabetes, which accounts for about 10% of the population (IDF, 2019). The vast majority of those are diagnosed with Type 2 diabetes mellitus (T2DM), which is considered to be caused predominantly by an unhealthy lifestyle. With such an increasingly negative trend, the need for more efficient treatment, which does not require very frequent face-to-face doctor appointments, is desired. A rise in digital technologies provides scalable solutions to offer intensive educational, behavioural and nutritional guidance, keeping strong medical background and supervision. Pioneering mobile applications appeared in the USA in the late 2000s, currently, several apps also exist in European countries and are beginning to be incorporated into national health systems and reimbursed by the insurance companies. To mention the most significant cases, Germany introduces the first apps within the legal framework of DiGA (Digitale Gesundheitsanwendungen) devices, several apps are being supported and reimbursed in Great Britain’s NHS system. Czech Republic, while not having a special category for such kind of treatment, offers a reimbursement through uncategorized medical devices. This thesis aims to assess the effectiveness of the diabetes treatment using the help of digital technologies and compare it to the current standards of care using the standard procedure of the health technology assessment (HTA). Contribution In his umbrella review, Timpel et al. (2020) finds out positive impact of telemedicine interventions on clinical outcomes of patients with diabetes and other chronic diseases. Moreover, Rinaldi et al. discovers that the mHealth interventions are cost-effective, with a cost per quality-adjusted life year (QALY) gained ranging between 0.4 and 62.5 percent of the GDP per capita. However, there is little to no evidence about such intervention, that use mobile app as the primary device and this thesis aims to evaluate this form of delivery of the treatment or support. Methodology For diabetes as a progressive chronic disease, Markov chain model with several illness stages will be estimated for the selected types of treatment similarly as proposed by Agnihothri (2020). Treatment group receives the treatment via the mobile app, control group continues receiving standard care. The model requires several sets of parameters, namely between-state transition probabilities, costs associated with a given time-period in a disease stage and health utility in a given stage – QALY. Parameters will be selected based on a combination of summary reviews of an existing literature and the outcomes of the clinical trials of the digital health companies. Annual discount rate of 3% will be applied for both the cost and health outcomes. Cost-effectiveness and cost-utility analysis will be performed based on the selected parameters and the final result will be delivered in a form of an Incremental Cost Effectiveness Ratio (ICER). The results will be checked for robustness by varying clinical and interventional parameters. Both base-case scenario and sensitivity analysis will be assessed with regard to the recommended threshold for the acceptance of the new technology. Outline Abstract Introduction Literature review Global burden of diabetes Use of digital technologies in diabetes treatment Health technology assessment Markov models in HTA Selection of model parameters Transition probabilities Costs related to the disease stage Health utility Results Sensitivity analysis Discussion and conclusion |