Health economics of tick-borne diseases

Worldwide, tick-borne encephalitis (TBE) and Lyme borreliosis (LB) present an increasing burden and threat to public health. Only vaccines against TBE are available but vaccination is likely too low for optimally reducing the TBE burden at the European level. Vaccines for LB are still in the process of development. Given the lack of health economic and cost-effectiveness studies in the field of TBE and LB, the thesis of Renata Šmit adds novel insights and makes an important contribution to scientific knowledge to the field.
This thesis focuses on vaccines, clinical and economic aspects of TBE and LB with the aim to develop novel models and innovative approaches for assessing the health and cost outcomes and cost-effectiveness of vaccination and evaluates diseases’ impact on public health. The first study on cost-effectiveness of vaccination against TBE, using a Markov model, was performed. Results show a favourable cost-effectiveness of vaccination for Slovenia. Next to cost-effectiveness of vaccination, full burden of TBE, expressed in disability-adjusted life years (DALYs), using correction for under-reporting and under-ascertainment was estimated. This is the first study to address this specific issue. The result indicates that the number of TBE cases with the acute disease of the second stage with CNS is 4.5 times higher than official reported cases. Findings show a high TBE burden for Slovenia dominated by neurological sequelae.
Continuous effort in development novel vaccines against LB is needed. Raising awareness, promoting knowledge about TBE and LB and prevention against these diseases to reduce their burdens, and corresponding public health impact are needed.

Keywords: Tick-borne diseases (TBDs), tick-borne encephalitis (TBE), Lyme borreliosis (LB), clinical course, treatment, therapeutic vaccines, anti-tick vaccines, vaccination, health economics, a Markov model, cost-effectiveness, disease burden model, disability-adjusted life years (DALYs)