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》和综合医疗保健系统等新的组织模式，医疗保险的可获得性更高，这使得医疗保健提供者和保险公司考虑整体成本和收益，而不是专注于个别服务提供“孤岛”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和健康保险扩展的平等要求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HCV感染和HIV感染的药物使用者带来了新的机遇和挑战。无论是广泛的社会经济影响和健康的经济效益，为个人的SUD，丙型肝炎病毒和艾滋病毒治疗需要进行评估，并传达给临床和政策决策者在这一新的环境的背景下。我们的P30卓越中心提案的总体具体目标，题为“综合医疗保健时代物质使用障碍，HCV和HIV治疗的健康经济学”，是开发和传播经济证据，为物质使用治疗政策和物质使用者的HCV和HIV护理提供信息，并通过满足综合医疗保健系统提供者和支付者的需求来增加这项研究的影响。我们建议的中心（CHERISH：药物使用障碍、HCV和HIV治疗干预的卫生经济学中心）包括方法学、HCV和HIV、传播和政策、试点赠款和培训、行政核心、政策咨询委员会和中心咨询委员会。核心领导者和研究者在多机构合作以及之前和正在进行的几次合作方面拥有丰富的经验。他们将利用参与每个NIH支持的研究项目的更广泛的专家圈子。CHERISH将由一位在SUD、HCV和HIV卫生经济研究方面具有丰富管理经验的知名国家专家领导。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。拟议的中心将作为国家SUD卫生经济学研究资源，促进研究人员之间的科学合作，为这些研究人员提供来自利益相关者的反馈，并与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。通过试点赠款和相关的培训活动，我们将提供培训，指导和职业发展的研究人员在SUD，HCV和艾滋病毒卫生经济学领域的新机会。这些活动将产生一批新的研究人员，他们具有进行方法合理和创新的SUD经济研究所需的技能，为SUD，HCV和HIV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.