Health Outcomes Research Program
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SRI International's Health Outcomes Research Program offers extensive expertise and experience in pharmacoeconomic and health outcomes consulting. We are distinguished by the scientific rigor with which we address relevant concerns. We apply our skills in health sciences to the complex issues facing providers of health care products and services in an increasingly cost-sensitive environment. |
Development of Chronic Disease Management Models for Mental Health Care Disorders
In this project, SRI developed a computerized clinical pathway model that captured the complexities of managing a chronic mental disorder in a managed care environment. The model was used to determine the financial and care implications for current and potential future service offerings, including nonpharmacological treatments, improved diagnostic methods, and patient education.
Identification of Disease Management Approaches for Cardiovascular Disease
For a major health care company expanding into disease management service provision, SRI examined three cardiovascular disease areas as targets for disease management approaches:congestive heart failure, secondary prevention of coronary heart disease, and prevention of stroke. Using nationally representative databases and a panel of experts, SRI identified potentially cost-effective interventions for these disorders and estimated the potential real dollar savings of implementing the selected interventions.
Pharmacoeconomic Clinical Trial of Antidepressants in a Managed Care Environment
In the first phase of this project, SRI reviewed existing clinical trials and literature and developed a protocol for a prospective pharmacoeconomic clinical trial, including procedures for identifying patients, collecting baseline measures, randomizing patients to treatment, collecting cost and quality-of-life data, and analyzing their relative cost-effectiveness. In the second phase, our protocol was implemented in five test sites. SRI was responsible for training staff, developing data collection forms and questionnaires, monitoring data collection, and conducting quality assurance reviews. The study is now entering the third phase, involving implementation of a full-scale trial.
Cost-of-Illness Analysis for a Chronic Respiratory Disease
SRI conducted a cost-of-illness analysis for a chronic respiratory disease as part of an assessment of the potential economic implications of successful development of a pharmaceutical treatment agent. Information was collected from nationally representative databases and from a panel of experts. Medical resource costs were estimated by severity group for hospitalizations, inpatient physician services, emergency room visits, outpatient physician visits, outpatient diagnostic procedures, nursing home stays, home health care, hospice care, prescription medications, and long-term oxygen therapy.
Innovation Workshop to Identify Disease Management Initiatives
SRI conducted two Innovation Workshops for a client with respect to two different chronic mental health disorders. The workshops identified needs of patients, physicians, and managed care institutions with respect to these chronic disorders and potential solutions to the problems in the identification and treatment of these disorders. These ideas were further evaluated by the client using new business venture screening criteria that the client had developed.
Cost-Effectiveness Analysis of a New Drug for Treatment of a Chronic Respiratory Disease
SRI conducted a cost-effectiveness analysis of a pharmaceutical agent that was under development for the treatment of a chronic respiratory disease. Results of the study were used to make a Phase IIa go/no-go decision. The objective of the analysis was to determine the degree to which reductions in medical resource utilization and costs could offset the cost of administering the new agent.
Cost-of-Illness Study for a Chronic Musculoskeletal Disease
Using nationally representative databases combined with data from a longitudinal study of patients, SRI estimated the yearly direct and indirect costs of a chronic musculoskeletal disease. SRI also prepared a manuscript suitable for publication in a major medical journal on the current and future annual incremental and nonincremental costs of illness of this disease. The manuscript is currently undergoing review. Results will also be used by the client in its marketing campaign for a new pharmaceutical to treat this disease.
Plan for a Health Economics Evaluation during a Phase IIb Clinical Trial of a New Drug for Acute Ischemic Myocardial Syndromes
In the first phase of this study, SRI developed background information on acute ischemic myocardial syndromes, including epidemiology, traditional (current) management approaches, and expected outcomes, as well as costs, side effects, and complications. This information was the basis for a plan for the economic evaluation (cost-effectiveness) of a new agent for the management of acute ischemic myocardial syndromes. In the second phase, SRI developed the economic protocol to evaluate the cost-effectiveness of this drug. The economic data is being collected in conjunction with a late Phase IIb clinical trial being conducted in the United States and Europe.
Development of a Cost-Effectiveness Model for a New Antidepressant in a Medicaid Environment
SRI was retained by a pharmaceutical company to conduct a study to determine whether the company's specific serotonin reuptake inhibitor (SSRI) for the treatment of clinical depression was cost-effective in the Medi-Cal environment. The study involved conducting a survey of Medi-Cal service providers and developing a computerized model of treatment pathways. The study demonstrated that greater costs during the treatment period would eventually be recovered through lower posttreatment costs (e.g., costs for unresolved depression or repeat of treatment for unsuccessful patients).
Review of a Cost-Minimization Study of Non-steroidal Anti-Inflammatory Drugs
SRI was retained by a pharmaceutical company to review a study conducted in a major medical school showing that the cost of the company's new NSAID would be more than compensated for by a reduction in hospitalization costs associated with bleeding ulcers. SRI found that some of the numbers in the study did not agree with previously published literature and also found logical and numerical inconsistencies in report tables. We, the university, and the client eventually concluded that the original results were erroneous and could not be used to support the company's marketing efforts.
Proton Pump Inhibitor / H2 Antagonist Market Projection Model
SRI developed a model for forecasting proton pump inhibitor (PPI) and H2 antagonist markets out to the year 2005. Market share and revenues by product were calculated for three indications: ulcers, gastroesophageal reflux disease, and Zollinger-Ellison Syndrome. The model was embedded in a spreadsheet and included graphical and tabular output of market forecasts; model parameters were clearly identified and are easy to modify. The client used this model for product management decisions.
Cost-Minimization Study of an Ulcer Maintenance Drug Therapy in Medicaid Environments
SRI was retained by a pharmaceutical company to provide an unbiased evaluation of the merits of a study that purported superior cost-effectiveness for a competitor's product. SRI found that the original study was methodologically flawed and the results could not be relied on. SRI provided testimony to the Medi-Cal Therapeutic Drug Advisory Committee concerning our findings, and the committee recommended against accepting the cost-effectiveness findings of the reviewed study. The results of the SRI study were later presented to the Medicaid programs in Mississippi, Georgia, and Tennessee.
Cost-Minimization Study for Antibiotics in Medi-Cal
SRI conducted a study to determine the fiscal impacts to the State of California of the addition of a new antibiotic for the treatment of otitis media in children age 3 and under and for use in treating patients age 50 and over for lower respiratory infections. The results of the study were presented to Medi-Cal as part of the successful formulary registration and negotiation process.
Review Project
SRI was retained by the California Department of Health Services to evaluate the effects of a claims-based retrospective therapeutic drug utilization review (DUR) system on utilization of Medi-Cal covered services and Medi-Cal costs. The DUR evaluation was based on a classical prospective design, which involved the collection and analysis of pre- and postintervention data for two matched county groupings (the experimental or DUR group and the control group). The results of the experiment showed no statistically significant change in overall Medi-Cal costs or in drug costs in the DUR counties relative to the control counties after the implementation of DUR.
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