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: 8663905
• 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 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8663905
• 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 Savings; 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; Patients; Pharmaceutical Preparations; Phase; Population; Prognostic Marker; Quality of life; Relative (related person); Research; Research Personnel; Research Training; Risk; Science; Severity of illness; Societies; TNF gene; Techniques; Therapeutic; Time; Training; Tumor Necrosis Factor-alpha; Ulcerative Colitis; Weight; Work; adalimumab; base; career; clinical practice; clinical remission; comparative; comparative effectiveness; cost; cost effective; cost effectiveness; disability; economic impact; effective therapy; effectiveness research; health economics; improved; infliximab; insight; intervention effect; policy implication; 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）：了解各种疗法在终身复杂的慢性疾病中的最佳用途对于当前的医疗保健任务是至关重要的，即最大化健康和最小化成本。这项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专注于复杂慢性疾病的药物经济学的独立卫生服务研究人员。我的主要职业目标是应用健康经济学和决策科学，以最佳使用各种药物治疗的方式为健康政策提供信息。在接下来的五年中，我将重点介绍炎症性肠病（IBD）（克罗恩病[CD]和溃疡性结肠炎[UC]）生物学疗法的药物经济学。生物制剂目前是IBD中最有效，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的健康和经济学，以及如何更具成本效益的生物制剂使用。该K08奖将帮助我完成以下培训和职业目标：（1）获得健康经济学和决策科学的必要技能，以评估复杂慢性疾病的药物经济学，（2）成为研究临床策略比较成本效益的独立卫生服务研究者。为了实现这些目标，我组建了一个由小学导师Jay Bhattacharya博士组成的指导团队；联合官员保罗·怀斯（Paul Wise）博士；两位顾问，玛格丽特·布兰多（Margaret Brandeau）博士和杰里米·戈德霍伯特（Jeremy Goldhaber-Fiebert）博士。培训将包括正规课程和个人指导。该提案中的研究目标是出于以下问题的激励：鉴于IBD患者概况的各种治疗选择和差异，什么是 使用生物制剂来维持健康并降低成本的最佳方法？该项目具有三个特定的目的：目标1：通过确定对患者预后的利用趋势和治疗效果，以表征CD和UC中生物制剂的药物经济学。目标2：确定生物学cD和UC患者生物疗法的成本效益。目标3：确定健康政策的影响，如果在CD和UC患者中使用生物制剂时采用了最佳的成本效益策略。我将通过使用计量经济学方法的大型数据库分析来解决这些目标，这是比较头对头模拟中生物制剂的两种比较成本效益分析，以及两个相互竞争的风险纳入的分析，如果对生物学的成本有效使用，则可以详细介绍健康政策，以成为标准的临床实践。