APPROACHES TO THE EVALUATION OF MEDICAL TECHNOLOGIES ON THE EXAMPLE OF DETERMINATION OF ECONOMIC PERCEPTION OF CANCER PREVENTION IN UKRAINE BY VACCINATION FROM PAPILOMAVIRUS INFECTION
Keywords:
health technology assessment, human papillomavirus, vaccination, Markov simulation, economic feasibilityAbstract
The purpose of the work is to determine the economic feasibility of preventing cervical cancer in Ukraine by introducing a continuous vaccination against a 12-year-old girl with a papillomavirus infection.
Methods. Markov simulation was used to determine the incremental coefficient of economic feasibility (ICER) on the basis of epidemiological data on morbidity and mortality from cervical cancer in Ukraine. Costs for the provision of medical care under the cervical cancer and the cost of vaccination calculated on the basis of the tariffs of private clinics (in Ukraine there are no state tariffs). It was assumed that the effect of vaccination persisted throughout life, taking into account it only in the vaccinated population. The time horizon – the period of survival of girls, which at the beginning of the study is 12 years. The duration of the Markov cycle is 1 year. Discounting the duration of life and the cost of spending was carried out at a rate of 3% per year. The calculation is made for a divalent vaccine. The sensitivity analysis was carried out in three parameters.
Results. Taking into account the accepted assumptions and limitations of the introduction of HIV vaccination in Ukraine, it will prevent the prevention of 1592 Cervix cancer cases, the preservation of 2059 quality-adjusted life-year (QALY) and the reduction of the cost of medical care for Cervical Cancer in the amount of UAH 41 400 000 (all results per 100,000 vaccinated persons). The amount of additional costs for the vaccine and its introduction was UAH 5140 per vaccinated person. The ICER index is UAH 229 575, which is 3.3 times the gross domestic product in Ukraine per 1 person in 2017 (UAH 70 224).
Conclusions. Given the assumptions and actual cost of the vaccine, vaccination against HPV infection with a view of preventing Cervical cancer in Ukraine is currently economically inappropriate.
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