Center connects clinical research, economicsby Michael BakerPublic Relations Although economic principles infuse medical research, they often receive little attention from researchers. But in July 2003, MUSC’s Center for Health Economic and Policy Studies opened, bridging the gap between clinical research and economics. The center, led by director David Bradford, Ph.D., maintains three goals: providing assistance to researchers at MUSC, conducting extramurally funded research, and disseminating research findings to as broad an audience as possible. Of the three, MUSC researchers could benefit most from the center’s assistance in grant proposals and research. “We do a lot of pro bono work with other departments, helping grant writers with the economic aspects of their proposals,” Bradford said. “It’s important for us to get to the principal investigators before they send their proposals in for approval.” The center’s input could save investigators a great deal of time and improve the chances that their proposals will be accepted. “Quite often, grant-funding organizations initially deny proposals that don’t include a cost-effectiveness analysis,” he explained. By including such analyses in the proposal’s first submission, investigators reduce turnaround time and increase the chance of receiving funding. Far from arbitrary addenda, economic analyses underscore the basic economic principle inherent not only in medical research, but in all decision-making situations—cost versus benefit. “Recently, we helped an investigator whose research focused on a new way to target interventions for people with hypertension,” Bradford recalled. “But the success of new therapies hinges on how costly and effective they are.” Ideally, a new therapy would provide a more effective, less expensive alternative to existing treatments. But more often, he said, the center’s analyses reveal that the new therapy is both more effective and more expensive. “It’s not as simple as finding a better outcome,” he said. “We help researchers determine whether or not the gain is worth the expense.” The center hopes to prove its utility by providing assistance free of charge to MUSC researchers. At last count, MUSC researchers had consulted center employees 144 times, totaling more than 600 hours of collaboration. But it also offers services outside of the university. Bradford recently spoke at an MUSC seminar about his work with James Zoller, Ph.D., and Gerard Silvestri, M.D., examining the concept of time preference in health care technology. Silvestri served as the principal investigator on a study related to the development of a new computer tomography (CT) machine designed for the early detection of lung cancer. Although such preventative medicine seems ideal, Silvestri, Zoller and Bradford conducted a demand analysis to determine the new machine’s viability in the marketplace. “The complicating factor was figuring out the demand for preventative medicine,” Bradford explained. “A dollar today is worth more than a dollar tomorrow, so we had to determine whether people would be willing to spend money now for better health later.” He added that many people prefer good things now and bad things later, so although it may seem counterintuitive, many people are willing to save money now (i.e., decline to pay for preventative health) despite the risk of poor health later. In another example of external consulting, the center worked with the state Medicaid program to identify best-practice strategies. One strategy involved a program to improve infant and maternal health. “Medicaid was contemplating whether or not to send more workers to the homes of new mothers to teach them how to care for their infants and themselves,” Bradford said. “The main concern was determining if the additional educational outreach would be worth the cost.” After researching the situation, Bradford discovered that the expanded outreach program would save a great deal of money while improving community health as well. “For every dollar spent on educating new mothers, Medicaid saved more than $1.50 in future costs,” he said. “The program offered preventative medicine, reducing the amount spent on acute services in the future. From a community standpoint, the mothers used the preventative education to take better care of their infants, reducing the children’s primary care visits later in life.” Spurred by the center’s affirmation, Medicaid expanded the program. Bradford and his colleagues hope they can engage in similarly successful collaborations with researchers at MUSC. Assisting with grant proposals free of charge demonstrates the depth of the center’s enthusiasm and earnestness. In addition to cost-effectiveness and typical health economics-related support, faculty members also can help principal investigators design a research project from scratch. “We just want to continue to demonstrate that we’re needed,” Bradford said. “We’ve shown that to be true in our collaborations thus far, but there are still a lot of departments at MUSC that could use our services.” The center reaches out to the university community in other ways as well, said Executive Director Loretta Lynch-Reichert. The third Tuesday of every month marks a luncheon series that allows researchers to discuss their findings and get feedback on current research and grant proposals. The center also sponsors a seminar series that brings respected researchers from across the country to MUSC. “We’ve had scholars from Northwestern, Yale, the University of North Carolina and Duke present their findings and share their research,” Reichert said. Not content merely to play the role of sidekick, the center also conducts research of its own. Bradford studied television advertisements for prescription drugs, examining the advertisements’ effects on patient-doctor interaction. Richard Lindrooth, Ph.D., the center’s associate director, researched the impact of a hospitals’ financial success on their quality of care; according to the center’s annual report, he’s also leading a paper examining how hospitals’ service offerings affect financial performance. Since its inception, the center has received more than $2 million in grant money for its research. “From the perspective of a non-economist, I find the center’s work fascinating,” Reichert asserted. “I don’t think the university knows enough about us, but once they learn what we have to offer, I believe they’ll really appreciate what we can do.” “We’re well on our way to being one of the top three or four centers for economic research in the nation,” Bradford agreed. “Our ultimate goal is to create a seamless integration of bench, clinical, economic and policy research at MUSC.” For information on the Center for Health Economic and Policy Studies,
visit http://www.musc.edu/cheps.
Friday, Sept. 24, 2004
|
|