Pharmaco-economics and Optimal Strategies of Biologics Use in Inflammatory Bowel

描述（由申请人提供）：了解各种治疗方法在终身复杂慢性疾病中的最佳使用对于实现健康最大化和成本最小化的当前医疗保健任务至关重要。这份K08奖提案概述了一个培训和研究计划，以促进我发展成为一名独立的卫生服务研究员，专注于复杂慢性疾病的药物经济学。我的主要职业目标是应用卫生经济学和决策科学，为各种药物疗法的最佳使用提供卫生政策信息。在接下来的五年里，我将专注于炎症性肠病（IBD）（克罗恩病[CD]和溃疡性结肠炎[UC]）生物治疗的药物经济学。生物制剂是目前IBD最有效和最昂贵的治疗选择。我的项目旨在回答生物疗法如何影响IBD的健康和经济学，以及如何更经济有效地使用生物制剂。这个K08奖将帮助我完成以下培训和职业目标：(1)获得必要的卫生经济学和决策科学技能，以评估复杂慢性疾病的药物经济学；(2)成为一名独立的卫生服务研究员，调查临床策略的相对成本效益。为了实现这些目标，我组建了一个指导团队，包括主要导师杰伊·巴塔查里亚博士；共同导师保罗·怀斯博士；两位顾问Margaret Brandeau博士和Jeremy Goldhaber-Fiebert博士。培训将包括正式课程和个人指导。本提案的研究目标是由以下问题驱动的：考虑到各种治疗选择和IBD患者概况的差异，什么是

DESCRIPTION (provided by applicant): Understanding the optimal use of various therapies in life-long complex chronic diseases is vital to the present health care mission of maximizing health and minimizing costs. This K08 award proposal outlines a training and research plan to facilitate my development into an independent health services researcher focusing on the pharmaco-economics of complex chronic diseases. My main career goal is to apply health economics and decision science to inform health policy on the optimal use of various pharmaco-therapies. In the next five years, I will focus on the pharmaco-economics of biologic therapies in inflammatory bowel disease (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]). Biologics are currently the most effective and most expensive therapeutic options in IBD. My project seeks to answer how biologic therapies have impacted the health and economics of IBD, and how biologics can be used more cost-effectively. This K08 award will help me accomplish the following training and career goals: (1) to acquire necessary skills in health economics and decision science to evaluate the pharmaco-economics of complex chronic diseases, (2) to become an independent health services researcher investigating the comparative cost-effectiveness of clinical strategies. To achieve these goals, I have assembled a mentoring team comprised of primary mentor, Dr. Jay Bhattacharya; co-mentor, Dr. Paul Wise; two advisors, Dr. Margaret Brandeau and Dr. Jeremy Goldhaber-Fiebert. Training will include formal courses and individual mentoring. The research goals in this proposal are motivated by the following question: Given the variety of therapeutic options and differences in IBD patient profiles, what is the best way to use biologics to sustain health and decrease costs? The project has three specific aims: Aim 1: To characterize the pharmaco-economics of biologics in CD and UC by determining the utilization trends and treatment effects on patient outcomes. Aim 2: To determine the cost-effectiveness of biologic therapies for biologic-naive CD and UC patients. Aim 3: To determine the health policy implications if optimal cost-effective treatment strategies were adopted in the use of biologics in CD and UC patients. I will address these aims through a large database analysis using econometric methods, two comparative cost- effectiveness analyses that compare biologics in head-to-head simulations, and two competing risk-analyses that elaborate health policy implications if cost-effective use of biologics were to become standard clinical practice.