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

• 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
• 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
• 来源: https://reporter.nih.gov/project-details/10658457
• 关键词: Acceleration; Aducanumab; Adverse effects; African American; Age of Onset; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Alzheimer' s disease therapeutic; Amyloid; Amyloid beta-Protein; Black American; Black Populations; Calibration; Caregiver Burden; Caregivers; Caring; Clinical Trials; Communities; Continuity of Patient Care; Cost Effectiveness Analysis; Costs and Benefits; Data; Diagnosis; Disparity; Early treatment; Econometric Models; Economics; Elements; Equation; Family; Family member; Financial Hardship; Flowers; Focus Groups; Grant; Heterogeneity; Hispanic Americans; Inequality; Life Expectancy; Literature; Logit Models; Measures; Medicare; Methodology; Methods; Minority Groups; Modeling; Monoclonal Antibodies; Motivation; Outcome; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Phase; Policies; Population; Prevalence; Probability; Quality-Adjusted Life Years; Race; Reduce health disparities; Research; Research Methodology; Resources; Risk; Severity of illness; Structure; Therapeutic; United States; United States Centers for Medicare and Medicaid Services; United States Food and Drug Administration; Update; care giving burden; caucasian American; clinical efficacy; clinical trial enrollment; community based participatory research; cost; cost effectiveness; cost estimate; data modeling; discrete data; economic value; ethnic difference; ethnic minority; ethnoracial; ethnoracial minority; experimental study; family burden; health equity; healthy aging; improved; markov model; models and simulation; novel; novel therapeutics; preference; racial difference; racial minority; racial population; treatment and outcome; treatment disparity; trend; underserved area; uptake

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.

项目概要 该项目的目的是结合使用马尔可夫模型、规定偏好数据和计量经济学 治疗接受模型，用于计算新疗法的成本、效益、社会价值和健康公平影响 治疗或阿尔茨海默病和阿尔茨海默病相关痴呆（AD/ADRD）。在这个项目中，我们 将研究 AD/ADRD 新疗法的成本效益模型对健康公平的影响 结合马尔可夫模型、文献数据和临床试验，基于社区 具有焦点小组和实验偏好数据的参与式研究（CBPR）。首先，我们将更新我们的 现有成本效益马尔可夫模型（为早期阿尔茨海默病的 aducanumab 和 donanemab 开发 美国的疾病）将种族特定的输入纳入起始值和转移概率。 接下来，我们将通过与高危非裔美国人/黑人开展 AD/ADRD 焦点小组合作来参与 CBPR 贫困、服务不足地区的个人（弗吉尼亚州里士满）。在此，我们将利用现有的关系 与致力于健康老龄化的社区合作伙伴合作。我们还将与护理人员进行焦点小组讨论 了解照顾者负担的影响。我们将使用模型的结果来衡量经济 使用来自 Discrete 的实验规定偏好数据减少不同人群的 AD/ADRD 的价值 选择实验。最后，我们将使用潜在的组合来估计治疗接受模型 选择和混合 Logit 模型来控制观察到的和未观察到的偏好异质性 不同种族群体之间以及种族群体内部。我们将使用国家标准来校准我们的模型 具有代表性的医疗保险数据，用于模拟使用率以及新疗法的后续成本和收益 再加上健康公平的影响。最后，我们将根据占用率开发模拟模型 确定可用于确保新治疗改善健康公平的政策变化。