Health Economics of Substance Use Disorder, HCV, and HIV Treatment in the Era of Integrated Health Care

 描述(由申请人提供)：美国医疗保健系统正在朝着更综合的方法发展，以改善美国人的健康。通过《平价医疗法案》(Affordable Care Act)和综合医疗系统等新的组织模式获得更多的医疗保险，促使医疗服务提供者和保险公司考虑总体成本和收益，而不是专注于个别服务交付的成本和收益。对于物质使用者来说，物质使用障碍(SUD)和精神健康保险覆盖范围的平等要求以及健康保险的扩大为综合护理提供了新的机会。它们还为用高效和昂贵的药物治疗丙型肝炎病毒感染者和艾滋病毒感染者带来了新的机遇和挑战。在这种新的环境下，需要评估广泛的社会经济影响和对个人的SUD、丙型肝炎和艾滋病毒治疗的健康经济效益，并将其传达给临床和政策决策者。我们的P30卓越中心提案的总体具体目标是“综合医疗保健时代物质使用障碍、丙型肝炎病毒和艾滋病毒治疗的健康经济学”，旨在开发和传播经济证据，为药物使用治疗政策和药物使用者的丙型肝炎和艾滋病毒护理提供信息，并通过解决综合医疗保健系统提供者和付款人的需求来增加这项研究的影响。我们建议的中心(HERISH：药物使用障碍、丙型肝炎病毒和艾滋病毒治疗干预的卫生经济学中心)包括方法学、丙型肝炎病毒和艾滋病毒、传播和政策、试点拨款和培训、行政核心、政策咨询委员会和中心咨询委员会。核心领导和调查人员在多机构合作以及之前和正在进行的几项合作方面拥有丰富的经验。他们将利用更广泛的专家圈子，参与NIH支持的每个研究项目。HERISH将由一位在SUD、丙型肝炎和艾滋病毒健康经济研究方面的知名国家专家领导，他拥有丰富的管理经验。我们将创新地使用基于网络的技术来补充频繁的面对面会议，并支持结构化的管理流程和行政跟踪系统。拟建的中心将作为国家SUD卫生经济学研究资源，进一步促进研究人员之间的科学合作，向这些研究人员提供利益相关者的反馈，并向临床和政策决策者进行外联。研究人员和决策者之间的这种互动对于NIH资助的SUD治疗策略研究产生最大影响至关重要。通过试点资助和相关培训活动，我们将为SUD、丙型肝炎和艾滋病毒卫生经济学领域的研究人员提供新的培训、指导和职业发展机会。这些活动将产生一批具有所需技能的新的研究人员，他们需要进行方法学上合理和创新的SUD经济研究，为SUD、丙型肝炎和艾滋病毒的治疗政策提供信息。

 DESCRIPTION (provided by applicant): The US healthcare system is evolving towards a more integrated approach to improving the health of Americans. Greater availability of health insurance through the Affordable Care Act and new organizational models such as integrated healthcare systems are leading health care providers and insurers to consider the totality of costs and benefits, instead of focusing on costs and benefits of individual service delivery "silos." For substance users, parity requirements for substance use disorder (SUD) and mental health insurance coverage and health insurance expansion present new opportunities for integrated care. They also present new opportunities and challenges for treating HCV-infected and HIV-infected substance users with highly effective and expensive medications. Both the broad societal economic impact and the health economic benefits for individuals of SUD, HCV, and HIV treatment need to be evaluated and communicated to clinical and policy decision makers in the context of this new environment. The overall specific aim of our P30 Center of Excellence proposal entitled "Health Economics of Substance Use Disorder, HCV, and HIV Treatment in the Era of Integrated Health Care" is to develop and disseminate economic evidence that informs substance use treatment policy and HCV and HIV care of substance users, and to increase the impact of this research by addressing the needs of integrated healthcare system providers and payers. Our proposed Center (CHERISH: Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV) includes Methodology, HCV and HIV, Dissemination and Policy, Pilot Grant and Training, and Administrative Cores, a Policy Advisory Board, and a Center Advisory Board. The Core leaders and investigators have extensive experience with multi-institutional collaborations and several previous and ongoing collaborations. They will draw on a wider circle of experts involved with each of the NIH-supported research projects. CHERISH will be led by an established national expert in SUD, HCV, and HIV health economic research who has substantial management experience. We will innovatively use web-based technology to supplement frequent in-person meetings and support a structured management process and administrative tracking system. The proposed Center will serve as a national SUD health economics research resource, furthering scientific collaborations among researchers, providing feedback to these researchers from stakeholders, and conducting outreach to clinical and policy decision makers. Such interaction between researchers and decision makers is essential for NIH-funded research on SUD treatment strategies to have its greatest impact. Through pilot grants and associated training activities, we will provide new opportunities for training, mentoring and career development for researchers in the field of SUD, HCV, and HIV health economics. These activities will yield a new cohort of investigators with the skills needed to conduct methodologically sound and innovative SUD economic research to inform SUD, HCV, and HIV treatment policy.