Joint Initiative in Vaccine Economics (JIVE) Project

背景资料。作为美国疫苗的主要购买者和免疫服务的支持者， 疾病控制和预防中心持续需要关于新的 疫苗和疫苗项目。 明确的目标。在过去的三年里，我们一直在疫苗经济学方面进行合作研究。 通过疫苗经济学联合倡议(JIVE)项目与疾病预防控制中心的同事们合作。我们建议继续这个项目， 在未来3年内启动4项新的研究。我们会： 1.进行Zoster公用事业评估，这是一项关于公用事业(偏好)对相关健康结果的研究 成人接种带状疱疹和水痘疫苗。这些实用程序将为分析 利益-风险权衡和成人带状疱疹疫苗接种的成本效益。 2.开展疫苗经济学应用研究，解决全球传染病中的首要问题 疾病政策； 3.设计和领导一项经济研究，为流感疫苗接种的政策决策提供信息； 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Zoster实用程序评估(特定目标1)，我们将使用预期 队列设计，将对两个亚组进行电话访谈：(1)新近带状疱疹患者-有 最近患有带状疱疹或带状疱疹后神经痛；及(2)社区代表--从以下项目中随机挑选的成年人 健康计划人口。研究人群将使用哈佛先锋的计算机化数据库进行识别 医疗协会和北加州凯撒永久医院。我们将管理一个结构化的、封闭式的 采访包括标准赌博和/或时间权衡问题，涉及与以下内容相关的健康州公用事业 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 非参数双变量检验和多变量模型。我们将检验假设HI：带状疱疹相关性疼痛 最近经历过带状疱疹的患者的评分比成年社区成员的评分更差。 对于具体的目标2、3和4，我们将与疾病预防控制中心合作选择和开发具体的研究问题 在时间线的前三个月内的同事。我们将根据研究问题选择合适的方法。 被选中了。 项目管理和协作努力。调查人员是唯一有资格进行这项工作的人。 这是一个总部设在哈佛大学的多学科团队，拥有决策分析方面的高级技能，这是一种推荐的方法 评估卫生政策的好处、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，在效用评估方面拥有高级技能；Grace Lee，医学博士，公共卫生硕士，儿科感染性疾病 具有成本效益分析专业知识的疾病专家。这支团队在当前的工作中一直很有成效 与疾控中心同事就百日咳、流感、脊髓灰质炎和疟疾疫苗接种政策的成本效益进行合作 乙肝。 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， 包括是否为成年人接种带状疱疹疫苗的问题。通过继续我们与疾控中心的合作 同事们，我们将着眼于提高国家应对问题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.