Measuring the Impact of the Value Flower and Unobserved Heterogeneity on the Cost Effectiveness and Use of Novel Treatments for Alzheimer's Disease and Related Dementias

衡量价值花和未观察到的异质性对阿尔茨海默病和相关痴呆症新疗法的成本效益和使用的影响

基本信息

批准号：
10658457
负责人：
ADAM J ATHERLY
金额：
$ 32.12万
依托单位：
VIRGINIA COMMONWEALTH UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-06-15 至 2025-05-31
项目状态：
未结题

项目摘要

Project Summary This purpose of this project is to use a combination of Markov models, stated preference data and econometric models of treatment take-up to calculate the costs, benefits, societal value and health equity impacts of novel treatments or Alzheimer disease and Alzheimer's disease-related dementias (AD/ADRD). In this project, we will study the health equity implications of the cost effectiveness models new novel treatments for AD/ADRD using a combination of Markov models, data from the literature and clinical trials, community based participatory research (CBPR) with focus groups and experimental preference data. First, we will update our existing cost effectiveness Markov model (developed for aducanumab and donanemab for early Alzheimer disease in the United States) in incorporate race specific inputs into the start values and transition probabilities. Next, we will engage in CBPR by conducting focus groups on AD/ADRD with at-risk African-American/Black individuals in a poor, underserved area (Richmond, VA). In this, we will leverage pre-existing relationships to engage with community partners working on healthy aging. We will also conduct focus groups with caregivers to understand the effect of caregiver burden. We will use the results of the models to measure the economic value of reducing AD/ADRD in different populations using experimental stated preference data from Discrete Choice Experiments. Finally, we will estimate models of treatment take-up using a combination of latent choice and mixed logit models to control for both observed and unobserved preference heterogeneity both between different racial groups and within racial groups. We will calibrate our models using nationally representative Medicare data to simulate take-up rates, and subsequent costs and benefits to new treatments plus the impact of health equity. Finally, we will develop simulation models based on the take-up rates to identify policy changes that could be used to ensure that new treatment improve health equity.

项目摘要该项目的此目的是结合马尔可夫模型，陈述的偏好数据和计量经济学用于计算新颖的成本，收益，社会价值和健康公平影响的治疗模型治疗或阿尔茨海默氏病和阿尔茨海默氏病与疾病有关的痴呆症（AD/ADRD）。在这个项目中，我们将研究成本效益的健康公平含义模型的新新型AD/ADRD的新型治疗方法使用马尔可夫模型的组合，文献和临床试验的数据，基于社区参与性研究（CBPR）具有焦点组和实验偏好数据。首先，我们将更新我们的现有的成本有效性马尔可夫模型（为阿尔茨海默氏症的阿杜省和多纳姆布开发美国的疾病）将种族特定的投入纳入起始值和过渡概率中。下一在一个贫穷，服务不足的地区（弗吉尼亚州里士满）。在此，我们将利用现有的关系与致力于健康衰老的社区合作伙伴互动。我们还将与护理人员进行焦点小组了解护理人员负担的影响。我们将使用模型的结果来衡量经济使用离散的实验既定偏好数据在不同人群中降低AD/ADRD的价值选择实验。最后，我们将使用潜在的组合估算治疗模型选择和混合logit模型以控制观察到的未观察到的偏好异质性在不同的种族群体和种族群体之间。我们将使用全国范围的模型来校准我们的模型代表性的Medicare数据，以模拟增加率，以及随后的新治疗费用和收益加上健康公平的影响。最后，我们将根据增加速率开发模拟模型确定可用于确保新待遇改善健康公平的政策变化。