Over the past 11 years, the 'Cost-Effectiveness of Preventing AIDS Complications' (CEPAC) team hasexpanded and refined its computer simulation of HIV disease in order to better address critical questions inHIV management. During the first two years ofthe R37 cycle, the CEPAC project has experiencedtremendous growth, outstanding productivity, and increased outreach and collaboration with otherNIAID-funded as well as other national and international research groups. During this time, the CEPACteam has published 19 peer-reviewed papers, with one more in press and two others submitted.
The specific aims for the next cycle of the grant (2010-2015) address critical areas of HIV clinical care andpolicy in the United States, while continuing the cutting-edge methodology and applications that havemaintained the CEPAC team as an internationally-recognized HIV research effort. The three specific aimsfor the next phase of the grant are:1. To examine the issue of when to start antiretroviral therapy in the US, taking into account a newerunderstanding of HIV disease complications and new approaches to HIV testing.2. To determine the clinical impact, value and optimal use of both new diagnostic technologies and existinglaboratory monitoring tests.3. To evaluate comprehensive approaches to HIV care that will optimize treatment outcomes in the contextof improved survival, an aging population, and an increasing prevalence of co-morbidities.During the next cycle of this project, we will use innovative simulation methods and incorporate new datafrom the best national sources to deliver high-impact studies that will directly influence HIV treatmentguidelines and policies in the United States.

Public Health Relevance

The long-term management of HIV disease is increasingly complicated by development of 'non-HIV'diseases and the high cost of HIV care, which includes not only medications, but also diagnostic tests andcare over many years of therapy. Disease simulation modeling and cost-effectiveness analysisareinvaluable tools for assessing the relative clinical benefits, costs and cost-effectiveness of HIV policies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Method to Extend Research in Time (MERIT) Award (R37)
Project #
4R37AI042006-14
Application #
7790944
Study Section
Special Emphasis Panel (NSS)
Program Officer
Huebner, Robin E
Project Start
1998-04-01
Project End
2015-07-31
Budget Start
2010-08-01
Budget End
2011-07-31
Support Year
14
Fiscal Year
2010
Total Cost
$837,603
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
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Schackman, Bruce R; Fleishman, John A; Su, Amanda E et al. (2015) The lifetime medical cost savings from preventing HIV in the United States. Med Care 53:293-301
Schackman, Bruce R; Leff, Jared A; Barter, Devra M et al. (2015) Cost-effectiveness of rapid hepatitis C virus (HCV) testing and simultaneous rapid HCV and HIV testing in substance abuse treatment programs. Addiction 110:129-43
Schackman, Bruce R; Haas, David W; Park, Sanghee S et al. (2015) Cost-effectiveness of CYP2B6 genotyping to optimize efavirenz dosing in HIV clinical practice. Pharmacogenomics 16:2007-18
Ross, Eric L; Weinstein, Milton C; Schackman, Bruce R et al. (2015) The clinical role and cost-effectiveness of long-acting antiretroviral therapy. Clin Infect Dis 60:1102-10
Pei, Pamela P; Weinstein, Milton C; Li, X Cynthia et al. (2015) Prioritizing HIV comparative effectiveness trials based on value of information: generic versus brand-name ART in the US. HIV Clin Trials 16:207-18
Linas, Benjamin P; Barter, Devra M; Morgan, Jake R et al. (2015) The cost-effectiveness of sofosbuvir-based regimens for treatment of hepatitis C virus genotype 2 or 3 infection. Ann Intern Med 162:619-29
Sax, Paul E; Sypek, Alexis; Berkowitz, Bethany K et al. (2014) HIV cure strategies: how good must they be to improve on current antiretroviral therapy? PLoS One 9:e113031
Linas, Benjamin P; Barter, Devra M; Leff, Jared A et al. (2014) The cost-effectiveness of improved hepatitis C virus therapies in HIV/hepatitis C virus coinfected patients. AIDS 28:365-76
McCormick, Alethea W; Abuelezam, Nadia N; Rhode, Erin R et al. (2014) Development, calibration and performance of an HIV transmission model incorporating natural history and behavioral patterns: application in South Africa. PLoS One 9:e98272

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