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

丙型肝炎病毒和艾滋病毒核心项目摘要 丙型肝炎(丙型肝炎)、艾滋病毒和物质使用障碍(SUD)是重大且相互交叉的公共卫生问题 美国面临的挑战。丙型肝炎病毒和艾滋病毒是影响药物使用者的两种最严重的疾病。 注射吸毒是美国感染丙型肝炎病毒的主要方式和注射中艾滋病毒的流行率 吸毒者是美国总人口的100倍。使用其他物质会导致大量的 额外的发病率、死亡率和治疗丙型肝炎病毒和艾滋病毒患者的费用。新疗法的高昂成本 丙型肝炎病毒治疗和高效的艾滋病毒药物突出表明，有必要了解 治疗吸毒者。在新时代，这些经济分析需要新的方法 《平价医疗法案》，该法案正在增加医疗保健的可及性，并促进新的综合医疗保健系统 组织模式。治疗干预健康经济学中心的总体目标 对于物质使用障碍，丙型肝炎和艾滋病毒)是开发和传播经济证据，告知 药物使用治疗政策和药物使用者的丙型肝炎病毒和艾滋病毒护理，并增加这方面的影响 通过满足综合医疗保健系统提供者和付款人的需求进行研究。为了支持这一目标， 珍爱丙型肝炎病毒和艾滋病毒核心将在治疗丙型肝炎病毒方面拥有独特的临床专业知识组合， HIV和SUD，与大型行政数据库合作的方法专业知识，以进行经济 分析、开发和使用模拟模型的经验，以便为丙型肝炎病毒和艾滋病毒的政策和SUD提供信息 政策。丙型肝炎病毒和艾滋病毒核心的具体目标是：(1)支持使用纵向数据进行 药物使用者治疗丙型肝炎病毒和艾滋病毒的经济评估 从医疗系统的角度来看，以及(2)推广先进的模拟建模方法， 丙型肝炎病毒、艾滋病毒和sud治疗经济评估中药物使用的纵向模式。我们会 确定包含来自各种设置的与政策相关的结果的数据集，并启动协作以 对SUD、丙型肝炎和艾滋病毒护理的经济后果进行创新分析。我们将推动 使用模拟建模，以便艾滋病毒、丙型肝炎病毒和SUD研究人员以前从未考虑过 模拟研究可以看到他们从干预试验和观察队列中收集的数据是如何 做出政策结论，我们将支持这些调查人员确保他们拥有 他们需要成功的工具。我们将研究关键的仿真建模参数，使用纵向 数据集，并展示如何在高级模拟模型中使用这些参数来评估丙型肝炎病毒、艾滋病毒 和苏德疗法。我们将与方法核心密切合作，以确保纵向数据可以 使用先进的生物统计学、计量经济学和临床流行病学方法进行分析， 传播和政策核心，以规划和执行传播活动，并与试点赠款和 培训核心，评估和指导试点项目，并进行数据分析和建模方面的培训。

HCV AND HIV CORE PROJECT SUMMARY Hepatitis C (HCV), HIV, and substance use disorder (SUD) are significant and overlapping public health challenges in the US. HCV and HIV are two of the most serious medical conditions affecting substance users. Injection drug use is the primary mode of HCV acquisition in the US and the prevalence of HIV among injection drug users is 100 times higher than in the general US population. Use of other substances leads to substantial additional morbidity, mortality, and costs for treating HCV and HIV patients. The high costs of new curative HCV treatments and highly effective HIV medications highlight the need to understand the economic impact of treating substance users. Novel approaches to these economic analyses are required in the new era of the Affordable Care Act, which is increasing healthcare access and promoting new integrated healthcare system organizational models. The overall aim of CHERISH (Center for Health Economics of TReatment Interventions for Substance Use Disorder, HCV, and HIV) 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. In support of this aim, the CHERISH HCV and HIV Core will have a unique combination of clinical expertise in the treatment of HCV, HIV and SUD, methodological expertise working with large administrative databases to conduct economic analyses, and experience developing and using simulation models to inform HCV and HIV policy and SUD policy. The HCV and HIV Core’s specific aims are: (1) to support the use of longitudinal data to conduct economic evaluations of treatments for HCV and HIV among substance users that address the integrated healthcare system perspective, and (2) to promote advanced simulation modeling methods that incorporate longitudinal patterns of substance use in economic evaluations of HCV, HIV and SUD treatment. We will identify data sets containing policy-relevant outcomes from a variety of settings, and initiate collaborations to conduct innovative analyses of the economic consequences of SUD, HCV, and HIV care. We will promote the use of simulation modeling so that HIV, HCV, and SUD researchers who have never before considered a simulation study can see how the data they collect from interventional trials and observational cohorts can be leveraged to make policy conclusions, and we will support these investigators to ensure that they have the tools they need to be successful. We will investigate critical simulation modeling parameters using longitudinal datasets and show how these parameters can be used in advanced simulation models to evaluate HCV, HIV, and SUD treatment. We will work closely with the Methodology Core to ensure that longitudinal data can be analyzed using advanced biostatistics, econometrics, and clinical epidemiology methods, with the Dissemination and Policy Core to plan and execute dissemination activities, and with the Pilot Grant and Training Core to evaluate and mentor pilot projects and conduct training in data analysis and modeling.