Jennifer P Ruger
Yale University
Project start date: 2009-01-15
Project end date: 2012-12-31
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ECONOMIC EVALUATION OF DRUG ABUSE TREATMENT AND HIV PREVENTION SERVICES FOR PREGN
Jennifer P Ruger, Assistant Professor
Yale University, 47 College Street, Ste 203, New Haven, Ct 06520-8047
Grant 5R01DA025555-02 from National Institute On Drug Abuse
Abstract: Economic evaluation of drug abuse treatment and HIV prevention services for pregnant women is critical to identify the most efficient and equitable use of scarce resources. Economic and policy research on the efficiency of drug abuse treatment and HIV prevention services among vulnerable populations such as women, adolescents and members of minority groups is necessary to improve drug abuse and HIV/AIDS services for these vulnerable and underserved populations. While work in this area continues to grow, there is still a dearth of rigorous economic evaluations of such programs, especially those that adhere to quality standards as recommended by the U.S. Panel on Cost Effectiveness in Health and Medicine. The overall objective of this study is to conduct the first economic evaluation of an innovative behavioral approach integrating Motivational Enhancement Therapy with Cognitive Behavioral Therapy (MET-CBT) as compared to standard Brief Advice (BA) within prenatal care to decrease use of a full range of substances (e.g., marijuana, cocaine, methamphetamines, alcohol, nicotine), to reduce HIV risk behavior and to achieve better infant health outcomes (e.g. longer gestations, greater birth weight, reduced medical consequences such as admission and length of stay in the Neonatal Intensive Care Unit (NICU)). The specific aims of this study are (1) to conduct cost analyses of the MET-CBT and BA intervention arms; (2) to conduct incremental cost-effectiveness analyses of the two interventions (MET-CBT and BA), vis-
Keywords: -vis each other, in terms of substance use and HIV risk reduction. The proposed research is responsive to PA-07-122 in that it proposes to conduct research related to cost-effectiveness and cost-utility analyses, services costs, methodological research, and the cross-cutting themes of HIV/AIDS and health disparities. The proposed research is grounded in sound microeconomic principles and standardized techniques as reported in the U.S. Panel on Cost Effectiveness in Health and Medicine, and proposes rigorous conceptual and methodological research to improve the evidence base on the unit costs and cost-effectiveness of substance abuse treatment and HIV prevention services. It builds on a NIDA-funded randomized controlled trial (R01-DA019135) of an innovate behavioral approach, which offers a new paradigm of treatment services, integrating MET-CBT within prenatal care compared to standard BA, and offering promise to improve access to and strengthen substance use treatment and HIV prevention services targeted at drug using pregnant women who are highly susceptible to HIV/AIDS. Drug abuse and high risk HIV behavior during pregnancy are major public health problems in the United States due to their impact on individual users, their offspring, and surrounding communities. Drug abuse and HIV prevention programs targeting pregnant women have the potential to be cost-effective due to the resultant fewer low-birth-weight babies and perinatal deaths, fewer physical, cognitive and behavioral problems during infancy and childhood, and the significant health benefits that can accrue to the mother. The overall objective of this study is to conduct the first economic evaluation of an innovative behavioral approach integrating Motivational Enhancement Therapy with Cognitive Behavioral Therapy (MET-CBT) as compared to standard Brief Advice (BA) within prenatal care to decrease use of a full range of substances (e.g., marijuana, cocaine, methamphetamines, alcohol, nicotine), to reduce HIV risk behavior and to achieve better infant health outcomes (e.g. longer gestations, greater birth weight, reduced medical consequences such as admission and length of stay in the Neonatal Intensive Care Unit (NICU))
Relevance: -vis each other, in terms of substance use, infant health outcomes and HIV risk reduction; and (3) to conduct incremental cost-utility analyses determining the net cost per Quality-Adjusted Life Year (QALY) saved respectively by each intervention arm (MET-CBT and BA), vis-
Project start date: 2009-01-15
Project end date: 2012-12-31
Budget start date: 1-JAN-2010
Budget end date: 31-DEC-2010
PFA/PA: Economic Evaluation Of Addiction Services
Jennifer P Ruger
Yale University 47 College Street, Ste 203 New Haven, Ct 065208047
Grant 5K01DA016358-05 from National Institute On Drug Abuse IRG: ZDA1
Abstract: Economic evaluation of drug prevention programs and treatment interventions is critical to identify the most efficient use of scarce resources. While work in this area continues to grow, there is still a dearth of rigorous economic evaluations of such programs. This K01 Award would allow Dr. Jennifer Prah Ruger to advance her skills to conduct health economic and policy research on the efficiency of addiction services among vulnerable populations such as women, adolescents and members of minority groups to ultimately improve addiction services for these underserved populations. The specific aims of this proposal are (1) to acquire advanced knowledge of the epidemiology and etiology of substance use disorders; (2) to develop greater understanding of clinical approaches to the assessment and treatment of drug use disorders and associated comorbid conditions; (3) to enhance knowledge and skills pertaining specifically to the economic evaluation of addiction services; and (4) to obtain ongoing training in the responsible conduct of research. Dr. Prah Ruger s career development plan includes supervised study with Linda B. Cottler, Ph.D. in relation to epidemiological and substance abuse issues; with Arlene Rubin Stiffman, Ph.D. on issues related to substance abuse and mental health services for adolescents; and with Michael T. French, Ph.D. and Milton C. Weinstein, Ph.D. on the methods of economic evaluation, along with coursework, grand rounds, relevant seminar series, and professional meetings. Dr. Prah Ruger will use the knowledge and skills developed through these career development activities to conduct three research projects. The first project includes an assessment of the cost effectiveness of a smoking cessation program for low-income pregnant women (Dr. Weinstein). The second project evaluates the incremental cost-effectiveness and cost-utility analysis of a three-arm public health intervention to prevent HIV and STDs in at-risk, drug-using women (Drs. Cottler and Weinstein). The third project examines the costs of addiction and mental health services for reservation- and urban-based American Indian youth (Drs. Stiffman and French). The proposed plan will provide Dr. Prah Ruger with the training, mentoring, time and resources to develop the specific skills and knowledge that will allow her to lead independent research on the economic evaluation of addictive services.
Keywords: cost effectiveness, drug abuse prevention, health care cost /financing, health economics, AIDS education /prevention, adolescence (12-20), drug addiction, female, health care policy, low socioeconomic status, medically underserved population, mental health service, pregnancy, sexually transmitted disease, smoking cessation, substance abuse epidemiology, behavioral /social science research tag, clinical research, human subject
Project start date: 2003-05-20
Project end date: 2009-04-30
5K01DA016358-05 (2007): $147897
5K01DA016358-04 (2006): $145427
7K01DA016358-03 (2005): $145433
Economic Evaluation Of Drug Abuse Treatment And HIV Prevention Services For Pregn
Jennifer P Ruger
Eph (school Of Public Health)yale University
Grant 1R01DA025555-01A1 from National Institute On Drug Abuse IRG: BSPH
Abstract: Economic evaluation of drug abuse treatment and HIV prevention services for pregnant women is critical to identify the most efficient and equitable use of scarce resources. Economic and policy research on the efficiency of drug abuse treatment and HIV prevention services among vulnerable populations such as women, adolescents and members of minority groups is necessary to improve drug abuse and HIV/AIDS services for these vulnerable and underserved populations. While work in this area continues to grow, there is still a dearth of rigorous economic evaluations of such programs, especially those that adhere to quality standards as recommended by the U.S. Panel on Cost Effectiveness in Health and Medicine. The overall objective of this study is to conduct the first economic evaluation of an innovative behavioral approach integrating Motivational Enhancement Therapy with Cognitive Behavioral Therapy (MET-CBT) as compared to standard Brief Advice (BA) within prenatal care to decrease use of a full range of substances (e.g., marijuana, cocaine, methamphetamines, alcohol, nicotine), to reduce HIV risk behavior and to achieve better infant health outcomes (e.g. longer gestations, greater birth weight, reduced medical consequences such as admission and length of stay in the Neonatal Intensive Care Unit (NICU)). The specific aims of this study are (1) to conduct cost analyses of the MET-CBT and BA intervention arms; (2) to conduct incremental cost-effectiveness analyses of the two interventions (MET-CBT and BA), vis-
Keywords: -vis each other, in terms of substance use, infant health outcomes and HIV risk reduction; and (3) to conduct incremental cost-utility analyses determining the net cost per Quality-Adjusted Life Year (QALY) saved respectively by each intervention arm (MET-CBT and BA), vis-
Project start date: 2009-01-15
Project end date: 2012-12-31