Health technology assessment: case study on breast carcinoma treatment in the Czech Republic
|Autor:||Mgr. Lenka Šlegerová|
|Rok:||2019 - zimní|
|Vedoucí:|| PhDr. Lucie Bryndová
|Typ práce:|| Diplomová
|Ocenění:||Pochvala ředitele IES FSV UK za vynikající diplomovou práci.
Nomination Deloitte Outstanding Thesis Award
|Abstrakt:||This thesis proposes an original method for assessing total costs of medical treatment. It defines the semi-Markov model with four states that
are associated with specific costs of the treatment, and not with patients’
health statuses. This method is applied to individuals’ treatment data
drawn from the Czech clinical practice in the treatment of the metastatic
HER2+ breast cancer.
The aim is to assess the cost-effectiveness of adding medication pertuzumab to the combination of trastuzumab+docetaxel within first-line
therapy and to examine whether using individual data on Czech patients
and the economic conditions leads to different results from foreign studies. Furthermore, employing censored data from the clinical practice in the
thesis complicates the estimation of patients’ overall survival in comparison to clinical-trials data that form random samples. Therefore, survival
functions were not only estimated by the Kaplan-Meier estimator but also
using the Cox proportional hazard model and the Accelerated failure time
model that both control for the effects of included covariates.
The addition of pertuzumab does not result in significantly longer patients’ survival based on the employed data. Since the treatment is associated with higher costs, adding pertuzumab is not considered to be
cost-effective. This discrepancy from the results of the international clinical trial CLEOPATRA could be attributed to dissimilar patients’ length