László Nagyjánosi

Cost-effectiveness of adding vaccination with the AS04-adjuvanted human papillomavirus 16/18 vaccine to cervical cancer screening in Hungary

BackgroundThe cervical cancer screening program implemented in Hungary to date has not been successful. Along with screening, vaccination is an effective intervention to prevent cervical cancer. The aim of this study was to assess the cost-effectiveness of adding vaccination with the human papillomavirus 16/18 vaccine to the current cervical cancer screening program in Hungary.MethodsWe developed a cohort simulation state-transition Markov model to model the life course of 12-year-old girls. Eighty percent participation in the HPV vaccination program at 12 years of age was assumed. Transitional probabilities were estimated using data from the literature. Local data were used regarding screening participation rates, and the costs were estimated in US

Mapping the Nottingham Health Profile onto the preference-based EuroQol-5D instrument for patients with diabetes

. We applied the purchasing power parity exchange rate of 129 HUF/

PDB24 DIRECT HEALTH CARE COSTS OF DIABETES MELLITUS IN HUNGARY

to the cost data. Only direct health care costs were considered. We used a 3.7% discount rate for both the cost and quality-adjusted life years (QALYs). The time horizon was 88 years.ResultsInclusion of HPV vaccination at age 12 in the cervical cancer prevention program was predicted to be cost-effective. The incremental cost-effectiveness ratio (ICER) of adding HPV vaccination to the current national cancer screening program was estimated to be 27 588

Cost-effectiveness of a risk-based secondary screening programme of type 2 diabetes.

/QALY. The results were sensitive to the price of the vaccine, the discount rate, the screening participation rate and whether herd immunity was taken into account.ConclusionsOur modeling analysis showed that the vaccination of 12-year-old adolescent girls against cervical cancer with the AS04-adjuvanted human papillomavirus 16/18 vaccine would be a cost-effective strategy to prevent cervical cancer in Hungary.

Contribution of clinical trials to gross domestic product in Hungary.

OBJECTIVE The aim of this study was to derive a function that can map the Nottingham Health Profile (NHP) questionnaire onto a utility measure, the EuroQol five-dimensional (EQ-5D) questionnaire index, for diabetic patients. METHODS A cross-sectional study was performed on diabetic patients in Hungary with different complications in which quality of life was measured by using both the NHP questionnaire and the EQ-5D questionnaire. Ordinary stepwise-backward least-squares regression was used to develop a mapping function. Adjusted R2, Akaikes information criterion, and root mean square error were used to assess the performance of the model. The robustness of the models was tested using 10-fold cross-validation and bootstrapping. RESULTS The best-fitting models were those that contained all the NHP statements as predictors and a stepwise reduced version that contained only 19 statements. The latter model, however, showed considerable variability in the selection of predictors. The adjusted R2 of the former model was 0.68, the root mean square error was 174, and the Akaikes information criterion was -559.9. CONCLUSIONS The expected value of the EQ-5D questionnaire can be reasonably predicted on the basis of results of the NHP in patients with diabetes mellitus. The mapping function of the NHP onto the EQ-5D questionnaire is capable of estimating the expected EQ-5D questionnaire utility values in a group of patients with diabetes. The functions applicability for individual-level predictions, however, is limited. Further research is needed to find out whether mapping functions developed in Central-Eastern European countries are transferable to Western European countries.

Modeling cost-effectiveness of cervical cancer screening in Hungary.

PDB24 DIRECT HEALTH CARE COSTS OF DIABETES MELLITUS IN HUNGARY Vokó Z, Nagyjanosi L, Kalo Z Eötvös Loránd University, Budapest, Hungary; Syreon Research Institute, Budapest, Hungary OBJECTIVES: Diabetes mellitus is responsible for a huge burden of disease. Our objective was to estimate the direct health-care costs of patients with diabetes in Hungary. METHODS: Real-world data were retreived from the National Health Insurance Fund database. Diabetic patients were defi ned as persons who fi lled in a prescription of oral antidiabetics (OAD) or insulin in Q3-Q4 2007. Study population was divided into two groups depending on whether they were hospitalized for major complications of diabetes in 2007–2008. Patients without hospitalization were further divided into three subgroups according to the use of drugs (only OAD, only insulin, OAD and insulin). In all subgroups, we estimated health-care costs for each cost item by age group in the whole study group and among those who actually used a particular service. Additionally, we took samples of patients who were hospitalized for specifi c complications, and estimated health-care costs for the fi rst and second year after the occurrence of the complication. Hungarian Forint values were converted to Euros by employing the 2008 GDP specifi c PPP exchange rate (1c = 157.64HUF). RESULTS: Mean health-care cost of 521,545 diabetic patients was c2125 in 2008. It was c4016 for those with hospitalization for complications, c1533 for OAD users without complications, and c2847 for insulin users without complications. Fifty-three percent of the total cost covered drug treatment and 27% acute hospital treatment; 26% of the total drug cost was spent on OADs and on insulin. CONCLUSIONS: Health-care cost of diabetes is already high in Hungary, especially care for its complications. Public health-care cost of diabetes exceeds 0.65% of GDP and 13% of total direct public health-care expenditure. Considering the burden of disease that manifests in premature mortality, reduction in QoL, and high cost, and the epidemiological trends, diabetes mellitus should be a public health priority in Hungary.

External validation of the Syreon diabetes model

The objective of this study was to develop a long‐term economic model for type 2 diabetes to describe the entire spectrum of the disease over a wide range of healthcare programmes. The model evaluates a public health, risk‐based screening programme in a country specific setting.

PDB82 Development of a Health Economic Model to Compare the Prevention, Treatment and Management Strategies of Type 2 Diabetes

Aim To determine the contribution of clinical trials to the gross domestic product (GDP) in Hungary. Methods An anonymous survey of pharmaceutical companies and clinical research organizations (CROs) was conducted to estimate their clinical trial-related employment and revenues. Clinical trial documents at the National Institute of Pharmacy (NIP) were analyzed to estimate trial-related revenues at health care institutions and the value of investigational medical products (IMPs) based on avoided drug costs. Financial benefits were calculated as 2010 US

PCN103 COST-EFFECTIVENESS ANALYSIS OF ADDING HPV VACCINATION TO CERVICAL CANCER SCREENING PROGRAM IN HUNGARY

purchasing power parity (PPP) values. Results Clinical trials increased the revenue of Hungarian health care providers by US

Health Technology Assessment Considerations of The Primary Care Model Programme

165.6 million. The value of IMPs was US