Methodology Core

PROJECT SUMMARY - METHODOLOGY CORE The overall aim of our National Center of Excellence is to develop and disseminate health economics research on healthcare utilization, health outcomes, and health-related behaviors that informs SUD treatment and HCV and HIV care for people who use drugs. In this renewal, we will emphasize financial sustainability, advanced methods, and knowledge translation as well as development of the next generation of rigorous researchers in our field. The Methodology Core addresses Center Aim 1 by providing not only expertise in developing and applying advanced economic evaluation methodologies to SUD and HCV/HIV care of people who use drugs, but also a deep understanding of the financing and payment mechanisms needed for financial sustainability. Economic evaluation encompasses cost-effectiveness and cost-benefit analysis and uses standard procedures and tools to estimate and compare intervention costs and consequences, including person-centered outcomes such as health-related quality of life. Health economics analysis addresses questions of value, choice, and affordability of health interventions by considering multiple stakeholder perspectives, multiple outcomes, and differences in timing of costs and benefits. In SUD research, health economists generally work with multiple stakeholders (e.g., clinicians, providers, payers) to define relevant costs and outcomes. The goal is not simply to identify interventions that are cost-saving; indeed, from a payer perspective, SUD interventions may never be truly cost-saving since treating SUD effectively means long-term engagement, on-going treatment, and longer life expectancy, and these costs are even higher among individuals also managing HCV and/or HIV. But after considering the many non-financial benefits, such as improved quality-of-life, improved productivity, or reduced criminal activity, SUD interventions may be deemed cost-saving or cost-effective from a societal perspective. Economic evaluation research can directly address these challenges by providing a detailed accounting of the costs to providers and informing financial decisions through evidence about the costs and benefits of new approaches, the cost to achieve clinical outcomes, potential financing mechanisms, and the effectiveness of sustainment strategies. We will address sustainability with our applied and methodological work in the following Core Specific Aims: 1) to expand and facilitate use of appropriate resources and tools by researchers and other stakeholders to design, conduct, and interpret economic analyses of interventions to improve care for SUD and HCV/HIV among people who use drugs, with a focus on real-world implementation and sustainment; and 2) to develop and disseminate innovative application of methods for economic evaluations of data derived from clinical trials of SUD and HCV/HIV interventions among people who use drugs that leverage data harmonization and econometric approaches to improve their accuracy and real-world relevance.