WP4

Assessing cost-effectiveness of different health intervention schedules taking NSEs into account

 We will conduct cost-effectiveness analysis (CEA) of vaccination strategies taking into account sex-differential NSEs. The CEAs will use a health service as well as a societal perspective and will be based on the vaccine effect estimates derived from the RCTs (WP1-3) and the observational studies (WP5-6) if RCT estimates are not available. Costs related to the intervention will include vaccines, cost of administration and parents’ cost (time, transport). Use of health services will include hospital admissions and to the extent possible out-patient visits and medication. In Denmark, individual level data will be extracted from the national registers on service use including DNPR, NRMPS, and GPs and specialists covered by the Public Health Insurance. We will study both total use of health services and use specifically related to eczema and wheezing/asthma. Total costs and disease specific costs will be estimated based on DRG values at hospital level and on Public Health Insurance gross expenditure at GP and specialist level. In Guinea-Bissau, use of health services will be based on household data combined with hospital data on admissions. Unit costs of health services will be available from an on-going study. Productivity losses of care-givers due to child illness will be estimated based on interviews.

Deliverables

 Sex-specific incremental cost effectiveness ratios (ICER) will be calculated using both disease-specific and general effect measures. Confidence regions of the cost effectiveness estimates will be determined and cost effectiveness acceptability curves developed.

Implications

 It will strengthen the interests if we can document major gains in cost effectiveness of new health intervention programs based on NSEs.

PhD student

 The PhD student will be placed at Department of Health Services Research, University of Aarhus. The PhD student will be supervised by Ulrika Enemark and Peter Aaby. The PhD student’s academic focus will continuously be evaluated by CVIVA's steering committee. Research results will be published in leading international journals and in conference proceedings, and in all cases, the Center and the Danish National Research Foundation be thanked for support. The PhD student will participate in all key meetings and activities of the Center and contribute to the Center's general activities.