Economics of Formulary Design and Mental Health Policy

描述（由申请人提供）：处方药已成为精神健康治疗的一个越来越重要的组成部分，近年来精神药物的成本迅速增加。然而，在我们对精神药物治疗的经济学知识方面存在重大差距。这个指导研究科学家发展奖将允许博士海登Huskamp，在精神卫生政策和经济机构的专业知识的健康经济学家，以补充她的经济工具与所需的知识和技能进行临床相关和政策重要的研究用于治疗精神疾病的处方药的经济学。该职业发展计划的具体目标是：1）更好地了解与精神药物使用相关的临床决策; 2）获得精神药理学的基本知识; 3）扩大影响处方药市场的重要经济机构的知识。在这项工作中，Huskamp博士将由她的赞助商Richard Frank博士和共同赞助商Andrew Nierenberg博士和Ernst Berndt博士指导。她的职业发展计划包括与Nierenberg博士一起指导研究与治疗决策相关的临床问题，以及Berndt博士和Frank博士关于制药市场的经济机构，以及课程和参加精神药理学“大圆桌会议”，相关研讨会系列和专业会议。Huskamp博士将利用通过这些职业发展活动开发的知识和技能进行三个研究项目。第一个项目研究了选择性5-羟色胺再摄取抑制剂（SSRls）类仿制药进入抗抑郁药的使用模式，成本和市场份额的影响，以及品牌抗抑郁药制造商对药品价格和促销支出的竞争反应。第二个项目评估了三级药物处方集所产生的经济激励，以及这些安排如何影响非老年人群的成本、使用模式和治疗指南的依从性。该项目包括与限制性处方集相关的权衡的经济福利分析。第三个项目研究了三级处方集对退休人员精神药物成本和使用模式的影响，并探讨了处方集对医疗保险增加处方药福利的精神健康成本的影响，以及对在这种福利下获得适当精神药物治疗的影响。拟议的职业发展计划将为Huskamp博士提供培训，指导，时间和资源，以发展技能，使她能够领导对精神疾病药物治疗经济学的独立研究。

DESCRIPTION (provided by applicant): Prescription drugs have become an increasingly important component of mental health treatment and the costs of psychotropic drugs have increased rapidly in recent years. However, there are major gaps in our knowledge about the economics of psychotropic drug treatment. This Mentored Research Scientist Development Award would allow Dr. Haiden Huskamp, a health economist with expertise in mental health policy and economic institutions, to supplement her economic tools with the knowledge and skills needed to conduct clinically-relevant and policy-significant research on the economics of prescription drugs used in the treatment of mental illnesses. The specific aims of this career development proposal are to: 1) develop a greater understanding of clinical decision-making related to the use of psychotropic drugs; 2) acquire basic knowledge of psychopharmacology; and 3) expand knowledge of the important economic institutions influencing the prescription drug market. In this undertaking, Dr. Huskamp will be guided by her sponsor, Richard Frank, PhD, and co-sponsors, Andrew Nierenberg, MD, and Ernst Berndt, PhD. Her career development plan includes guided study with Dr. Nierenberg on clinical issues related to treatment decision-making and Drs. Berndt and Frank on economic institutions of the pharmaceutical market, as well as coursework and participation in psychopharmacological "Grand Rounds," relevant seminar series, and professional meetings. Dr. Huskamp will use the knowledge and skills developed through these career development activities to conduct three research projects. The first project examines the effect of generic entry in the class of selective serotonin reuptake inhibitors (SSRls) on utilization patterns, costs, and market share among antidepressants as well as the competitive response of brand antidepressant manufacturers with respect to drug prices and promotional spending. The second project assesses the economic incentives created by three-tier drug formularies and how these arrangements affect costs, utilization patterns, and adherence to treatment guidelines in a non-elderly population. This project includes an economic welfare analysis of the tradeoffs associated with restrictive formularies. The third project examines the effect of a three-tier formulary on psychotropic drug costs and utilization patterns in a retiree population and explores the impact of formularies on the mental health costs of adding a prescription drug benefit to Medicare and on access to appropriate psychotropic drug treatment under such a benefit. The proposed plan of career development will provide Dr. Huskamp the training, mentoring, time and resources to develop the skills that will put her in a position to lead independent research on the economics of pharmaceutical treatment for mental illnesses.