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

炎症性肠病生物制剂使用的药物经济学和优化策略

• 批准号: 9109616
• 负责人: KT Park
• 金额: $ 15.37万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-15 至 2017-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9109616
• 关键词: Accounting; Address; Adopted; Adrenal Cortex Hormones; Adult; Affect; Anus; Award; Benefits and Risks; Binding; Biological Response Modifier Therapy; Charge; Child; Childhood; Chronic; Chronic Disease; Clinical; Colectomy; Complex; Computers; Cost Effectiveness Analysis; Cost Savings; Cost effectiveness research; Crohn' s disease; Data; Databases; Dependency; Development; Direct Costs; Disease; Disease remission; Dose; Economics; Epidemiology; Exhibits; Frequencies; Future; Gastroenterology; Gastrointestinal Diseases; Goals; Head; Health; Health Benefit; Health Expenditures; Health Policy; Health Services; Healthcare; Hospitalization; Ileal Reservoirs; Immune; Individual; Inflammatory; Inflammatory Bowel Diseases; Infusion procedures; Injectable; Inpatients; Intestines; Intravenous; Investigation; Life; Maintenance; Measurement; Medical; Medicare/Medicaid; Mentors; Methods; Mission; Modeling; Monoclonal Antibodies; Morbidity - disease rate; New Agents; Operative Surgical Procedures; Outcome; Outcome Measure; Outpatients; Patient-Focused Outcomes; Patients; Pharmaceutical Preparations; Phase; Population; Prognostic Marker; Quality of life; Research; Research Personnel; Research Training; Risk; Science; Severity of illness; Societies; TNF gene; Techniques; Therapeutic; Time; Training; Ulcerative Colitis; Weight; Work; adalimumab; base; career; clinical practice; clinical remission; comparative; comparative effectiveness; cost; cost effective; cost effectiveness; disability; economic impact; health economics; improved; individual patient; infliximab; insight; intervention effect; patient subsets; pediatric patients; policy implication; profiles in patients; simulation; skills; treatment effect; treatment strategy; trend

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.

描述（由申请人提供）：了解各种疗法在终生复杂慢性疾病中的最佳使用对于当前最大化健康和最小化成本的医疗保健使命至关重要。该 K08 奖项提案概述了一项培训和研究计划，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健康经济学和决策科学为卫生政策提供有关各种药物疗法最佳使用的信息。在接下来的五年中，我将重点研究炎症性肠病（IBD）（克罗恩病 [CD] 和溃疡性结肠炎 [UC]）生物疗法的药物经济学。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，以及如何更经济有效地使用生物制剂。该 K08 奖项将帮助我实现以下培训和职业目标：(1) 获得卫生经济学和决策科学方面的必要技能，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，研究临床策略的相对成本效益。为了实现这些目标，我组建了一个由主要导师 Jay Bhattacharya 博士组成的指导团队；共同导师 Paul Wise 博士；两位顾问，玛格丽特·布兰多博士和杰里米·戈德哈伯-菲伯特博士。培训将包括正式课程和个人指导。本提案中的研究目标是出于以下问题：考虑到治疗选择的多样性和 IBD 患者概况的差异，什么是 使用生物制剂维持健康和降低成本的最佳方法是什么？该项目有三个具体目标： 目标 1：通过确定使用趋势和对患者结果的治疗效果来描述 CD 和 UC 中生物制剂的药物经济学特征。目标 2：确定生物疗法对于未接受过生物治疗的 CD 和 UC 患者的成本效益。目标 3：确定在 CD 和 UC 患者使用生物制剂时采用最佳的成本效益治疗策略对卫生政策的影响。我将通过使用计量经济学方法的大型数据库分析、两个在头对头模拟中比较生物制剂的比较成本效益分析以及两个竞争风险分析来阐述这些目标，如果生物制剂的成本效益使用成为标准临床实践，则详细说明卫生政策的影响。