Joint Initiative in Vaccine Economics (JIVE) Project

背景作为美国主要的疫苗购买者和免疫服务的支持者， 疾病控制和预防中心一直需要有关新的客观经济信息。 疫苗和疫苗项目。 具体目标。在过去的3年里，我们一直在进行疫苗经济学方面的合作研究， 通过疫苗经济学联合倡议（JIVE）项目与CDC同事合作。我们建议继续这个项目， 在未来3年内启动4项新研究。我们将： 1.进行带状疱疹效用评估，这是一项关于健康结局相关效用（偏好）的研究 成人带状疱疹和水痘疫苗接种的成人。这些实用程序将为分析 利益-风险权衡和接种成人带状疱疹疫苗的成本效益。 2.开展疫苗经济学应用研究，解决全球传染病领域的一个最优先问题， 疾病政策; 3.设计并领导一项经济研究，为流感疫苗接种政策决策提供信息; 4.进行一项经济研究，解决一个新出现的免疫服务政策问题。 方法和研究设计。对于带状疱疹效用评价（具体目标1），我们将使用前瞻性 队列设计，并将对两个亚组进行电话访谈：（1）近期带状疱疹患者-患有 最近有带状疱疹或带状疱疹后神经痛;和（2）社区代表-成人随机选择从 健康计划人口。将使用哈佛先锋的计算机化数据库确定研究人群 Medical Associates和北方加州Kaiser Permanente。我们将管理一个结构化的，封闭式的 访谈，包括标准赌博和/或时间权衡问题，关于与以下相关的健康状态的效用 带状疱疹和成人水痘疫苗接种，以及重要的预测变量。统计分析将使用 非参数二元检验和多元模型。我们将测试假设HI：Zoster相关疼痛将 最近经历过带状疱疹的患者比成年社区成员更糟糕。 对于具体目标2、3和4，我们将与CDC合作选择和开发具体的研究问题 时间轴前三个月的同事。我们将选择适合研究问题的方法 选定. 项目管理和协作努力。调查员是唯一有资格开展这项工作的人。 这是一个多学科的团队，总部设在哈佛与先进的技能，在决策分析，一个推荐的方法， 评估卫生政策的效益、风险和经济影响。哈佛大学的项目负责人是特雷西 Lieu，医学博士，公共卫生硕士，儿科医生和研究人员，在疫苗经济学方面有十年的经验; Kim Thompson，博士， 风险和决策科学研究员，具有全球传染病分析经验;丽莎普罗瑟博士， 卫生经济学研究员与先进的技能，在效用评估;和格雷斯李，医学博士，公共卫生硕士，儿科感染 具有成本效益分析专长的疾病专家。这支队伍在目前的工作中非常富有成效。 与疾病预防控制中心的同事合作，研究百日咳、流感、脊髓灰质炎和 B型肝炎。 预期的政策影响。这项研究将为重要的疫苗政策决策提供关键数据， 包括是否给成年人接种带状疱疹疫苗的问题。通过继续与疾病控制中心的合作， 同事们，我们将致力于提高国家应对气候变化的能力和方法的长期目标。 关于疫苗和其他卫生干预措施的重要经济问题。

Background. As the nation's dominant purchaser of vaccines and supporter of immunization services, the Centers for Disease Control and Prevention have an ongoing need for objective economic information about new vaccines and vaccine programs. Specific Aims. For the past 3 years, we have been conducting collaborative research in vaccine economics with CDC colleagues via the Joint Initiative in Vaccine Economics (JIVE) Project. We propose to continue this project, initiating 4 new studies during the coming 3 years. We will: 1. Conduct the Zoster Utilities Evaluation, a study of utilities (preferences) for health outcomes associated with adult zoster and varicella vaccination of adults. These utilities will provide key data for analyses of the benefit-risk tradeoffs and the cost-effectiveness of vaccinating adults against zoster. 2. Carry out an applied study in vaccine economics that addresses a top-priority question in global infectious disease policy; 3. Design and lead an economic study to inform policy decisions for influenza vaccination; 4. Conduct an economic study that addresses an emerging immunization services policy question. Methods and Study Design. For the Zoster Utilities Evaluation (Specific Aim 1), we will use a prospective cohort design and will conduct telephone interviews with two subgroups: (1) Recent-zoster patients - adults who have recently had zoster or post-herpetic neuralgia; and (2) Community representatives - adults selected at random from health plan populations. The study population will be identified using the computerized databases of Harvard Vanguard Medical Associates and Northern California Kaiser Permanente. We will administer a structured, closed-ended interview that includes standard gamble and/or time trade-off questions about utilities for health states associated with zoster and adult varicella vaccination, as well as important predictor variables. Statistical analyses will use nonparametric bivariate tests and multivariate models. We will test the hypothesis HI: Zoster-associated pain will be rated worse by patients who have recently experienced zoster than by adult community members. For Specific Aims 2, 3, and 4, we will select and develop the specific research questions in collaboration with CDC colleagues during the first three months of the timeline. We will choose methods appropriate for the research questions selected. Project Management and Collaborative Efforts. The investigators are uniquely qualified to conduct this work. This is a multidisciplinary team based at Harvard with advanced skills in decision analysis, a recommended method of evaluating the benefits, risks, and economic effects of health policies. The Harvard-based project leaders are Tracy Lieu, MD, MPH, a pediatrician and researcher with a decade of experience in vaccine economics; Kim Thompson, PhD, a risk and decision sciences researcher with experience in global infectious disease analyses; Lisa Prosser, PhD, a health economics researcher with advanced skills in utility assessment; and Grace Lee, MD, MPH, a pediatric infectious disease specialist with expertise in cost-effectiveness analysis. This team has been highly productive in current collaborations with CDC colleagues on the cost-effectiveness of vaccination policies for pertussis, influenza, polio, and hepatitis B. Anticipated Policy Impact. This research will provide key data to inform important vaccine policy decisions, including the question of whether to vaccinate adults against zoster. By continuing our collaborative work with CDC colleagues, we will address the long-term goals of enhancing the nation's capacity and methodology for answering important economic questions about vaccines and other health interventions.