Jakub Hlávka: There is a lack of health economists in the Czech Republic. A new study programme will help educate them

7 Sep 2022 Jana Sosnová

A new master's degree programme in Applied Health Economics is being created at Masaryk University under the leadership of experts from the Faculty of Economics and Administration in cooperation with other departments. One of their external advisors is Jakub Hlávka, a specialist in health economics from the University of Southern California. In his opinion, what are the weaknesses of the Czech healthcare sector and why is it important to educate a new generation of economists who will deal with it?

Is it worth investing in health?

Our health is the most precious thing we have. As the standard of living rises, we can also expect an increased investment in the quality and length of life. However, not all such efforts are equally effective. It is most worthwhile to invest in prevention and early detection of disease, but very often we see wasteful use of resources, either due to the health system being overwhelmed or deliberately by quacks. Health economists must therefore examine each medical intervention in terms of the costs and benefits it will bring to the patient and society as a whole. At the same time, they must also help prioritize different investments.

Why is it important for economists to be involved in health and healthcare?

There are many reasons, but perhaps the most important is that we have limited resources – both financial and human. In the long run, it is not possible to provide all medical interventions to everyone, at all times. In order to maximise both the freedom of individuals with different value systems and the availability and quality of health care on a societal level, we need to study data carefully and respond to new technological developments. These are complex issues that have both an economic and a moral dimension.

How can economists inform public health policy?

Currently, the involvement of economists in health policy decision-making is very limited. Investments are often the result of political debates or based on the wishes of clinical experts. Economists can provide a broader, data-driven perspective on the costs and benefits of current and new programmes. For example, they can calculate how best to invest in preventing obesity, which further increases the risk of diabetes or cardiovascular disease. They can also help set reimbursement rates to incentivise care providers to improve quality and better coordinate care, which is the Achilles’ heel of the Czech healthcare system. Thoughtful investments in modern technologies such as information sharing, and better scheduling would save patients and health professionals a lot of time and money.

What are the weaknesses of the Czech healthcare system?

The Czech healthcare system has a reputation of a system where even the poorest person is not left without help. This is true in theory, but unfortunately, we do not have public data on differences in the quality of care – for example, whether patients from small and large towns have similar chances of surviving specific procedures. And although we have relatively little direct patient participation in health care costs and patients have relative freedom to choose their providers, in some areas many patients are relatively worse off, especially those with lower education and income. But because the answers to these paradoxes are still more or less guesstimates, I think the main weakness is the lack of data utilization to make better decisions across the system, including towards greater patient participation or developing incentives for providers to result in the best-possible outcomes, and the associated high-quality data collection and analysis at differnet levels, from the physician’s office to the national level.

How well developed is the field of health economics in the Czech Republic?

It is a relatively young field – even in the United States it has a tradition of only a few decades. In the Czech Republic, we do not have enough experts in this field at the moment. However, thanks to the initiative of the Faculty of Economics and Administration at Masaryk University, there is a tremendous opportunity to educate a new generation of experts in the Czech Republic to address this deficit in the public, non-profit and private sectors.

What topics have you been working on in the field of health economics for a long time?

I have been involved in many projects myself, but my research focuses on two main issues. The first is the ageing population and the increasing burden on the health and social systems that goes with it. Secondly, I am looking at the availability of new therapies, such as biological treatments. As an economist, I am working on reimbursement mechanisms that reward good clinical outcomes and limit the level of waste in the system, such as in the case of new Alzheimer's drugs now coming to market. At the same time, I have been working with researchers in the United States and Europe to analyse the economic burden of diseases and different pandemic interventions.

What prompted you to start collaborating with the Faculty of Economics and Administration?

Ten years of studying and working in the US have made me realise how necessary this work is, and I am eager to use my experience to help in any way I can in the Czech Republic. I am also very excited by the hard work done at the Faculty of Economics and Administration and at other departments at Masaryk University, which gives me hope that things can really move forward in the Czech Republic and the wider region. Moreover, this initiative has the support of the Dean of the Faculty and the Rector of MU. I myself would like to contribute at least in a small way to a better quality and availability of care for our grandparents' and parents' generation, and then for us and our children.

At the Faculty of Economics and Administration, you will advise on the creation of a new master's degree programme in Applied Health Economics. What will make this programme unique?

It will be the first in the Czech Republic to focus on the clinical and societal value of health care investments. And probably the best that students will get in the whole Central European region and beyond. The aim of the Faculty of Economics and Administration is to create a truly world-class study programme – which is why it plans to teach in English from the start, involving world-leading experts and drawing on cooperation with other Masaryk University departments. Quality, not quantity, is the key.

What will the new programme bring to future students and graduates?

I think the new programme will bring three key things to students. Firstly, the excellent quality of teaching across the best departments at several faculties of Masaryk University with the participation of visiting professors from abroad. Second, excellent conditions for professional development through internships and connecting students with alumni. And last but not least, a modern and human approach to studies with a great degree of flexibility in terms of choice and specialisation in studies. I believe that we will soon hear about many of the graduates of the programme and their work – whether they will help us to modernise the Czech healthcare system at an governmental level, help to ensure the availability of the most modern treatments across the system from a private sector position, or integrate economic thinking at the level of providers, insurers or other organisations operating at the social-health frontier.

In addition to the Faculty of Economics and Administration, other faculties of Masaryk University will also participate in the development of the study programme. What will this interdisciplinary cooperation look like?

Experts from the best departments of the Faculty of Medicine, Faculty of Science, Faculty of Law, Faculty of Social Studies and Faculty of Pharmacy will participate in the programme. They will play a key role, especially in teaching specialised subjects – not only will students gain knowledge in many areas, but they will also broaden their horizons and help them make new contacts with students and graduates from other disciplines. This will enable them to be more effective in their own careers, as they will gain flexibility and insight that few other programmes provide.

In addition to the Applied Health Economics programme, a new expert group will be created. What will be its goal?

If this effort succeeds, a centre of excellence will emerge in Brno and nationally, which will collaborate with many key institutions in healthcare, from basic research to clinical practice, and publish applied research. This will hopefully soon lead to the bestpossible decisions about the future of our health and social systems and responses to new opportunities and threats.

What are the next steps in the development of the curriculum and the expert group?

The task force is tasked with preparing the entire programme for accreditation so that it can admit its first students in 2025. At the same time, international cooperation with other top institutes in the Czech Republic and abroad and the preparation of scientific activities is expected to begin. All of this takes time and investment in people – yet I believe that in a few years we will look back on this effort as one of the best investments we could have made for our country.

New programme website

Jakub Hlávka is a research assistant professor at the University of Southern California (USC) in Los Angeles, where he is a professor of health economics and leads several research teams working on issues of population aging, access to new drugs, and reimbursement mechanisms. In addition to research, he teaches at the USC Medical and Public Policy Schools and is part of the Schaeffer Center for Health Policy and Economics, which is one of the top five centres in the world in the field. He was educated at the University of Economics in Prague, Georgetown University in Washington, D.C., and the Pardee RAND Graduate School in California. In his spare time, he enjoys swimming, cycling, and running, and is also a violinist in several classical ensembles.

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