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

总体项目摘要 美国的医疗保健系统正在朝着一种更加综合的方法发展，以改善人们的健康状况。 美国人通过《平价医疗法案》和新的组织机构， 综合医疗保健系统等模式是领先的医疗保健提供商和保险公司考虑 （c）将成本和效益作为一个整体，而不是将重点放在个别服务交付“筒仓”的成本和效益上。为 物质使用者、物质使用障碍（SUD）的平等要求和精神健康保险范围 医疗保险的扩大为综合护理提供了新的机会。他们还提出了新的 治疗HCV感染和HIV感染的药物使用者的机会和挑战 昂贵的药物。广泛的社会经济影响和健康经济效益， 需要对SUD、HCV和HIV治疗的个体进行评估，并与临床和政策沟通 决策者在这个新的环境中。我们的P30中心的总体具体目标是 优秀提案，题为“健康经济学的物质使用障碍，丙型肝炎病毒和艾滋病毒治疗， 综合卫生保健时代”是发展和传播经济证据，告知物质使用 治疗政策和药物使用者的HCV和HIV护理，并通过以下方式增加这项研究的影响： 满足综合医疗保健系统提供者和支付者的需求。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、丙型肝炎病毒和艾滋病毒、传播和政策、试点赠款和培训以及行政核心，a 政策咨询委员会和一个中心咨询委员会。核心领导人和调查人员有广泛的 具有多机构合作的经验，以及以前和正在进行的几次合作。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将是 由SUD，HCV和HIV健康经济研究方面的知名国家专家领导， 管理经验我们将创新地使用基于网络的技术，以补充频繁的面对面交流。 会议和支持结构化的管理流程和行政跟踪系统。拟议 中心将作为国家SUD卫生经济学研究资源，促进科学合作 在研究人员中，向这些研究人员提供利益攸关方的反馈，并开展外联活动， 临床和政策决策者。研究人员和决策者之间的这种互动对于以下方面至关重要： NIH资助的SUD治疗策略研究将产生最大的影响。通过试点赠款， 相关的培训活动，我们将提供新的培训、指导和职业发展机会 为SUD，HCV和HIV卫生经济学领域的研究人员提供。这些活动将产生一批新的 具有进行方法合理和创新的SUD经济研究所需技能的调查人员 告知SUD、HCV和HIV治疗政策。

OVERALL PROJECT SUMMARY 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.