Health Policy
Current Grants
Cornell ACISR in Late Life Depression
George S. Alexopoulos, MD, PI; Bruce Schackman, PhD, Co-Investigator
4/1/09 – 3/31/14
The Cornell Clinical Trials Unit is an HIV/AIDS therapeutic clinical trials unit affiliated with the AIDS Clinical Trials Group (ACTG)
Cost-Effectiveness of Preventing AIDS Complications
Bruce Schackman, PhD, Subaward PI (In collaboration with Kenneth Freedberg, MD, University of Massachusetts, PI)
National Institutes of Health/National Institute of Allergy and Infectious Diseases
8/1/2010 – 7/31/2015
Dr. Schackman’s role on this project will be to provide expertise in overseeing cost and quality of life parameter inputs into the CEPAC model associated with HIV treatment, co-morbidities, and drug-related toxicities. He will also assist in conducting the HIV policy analyses, with a particular emphasis on cost implications for U.S. policy makers. He has extensive experience deriving cost and quality-of-life parameters for the CEPAC cost-effectiveness model, and in conducting costing studies of HIV interventions in the U.S. and in Haiti. As a member of the CEPAC collaboration for over 10 years, he has established close working relationships with this project team.
Designing Payment and Performance Evaluation for Depression Care Management
Yuhua Bao, PhD, PI
Huibo Shao, M.S., M.A., Study Staff
NIMH Mentored Research Scientist Development Award (K01)
04/01/10 – 01/31/15
This award provides the necessary support to facilitate Dr. Bao's successful transition to an independent mental health services investigator, with the career goal of providing much-needed evidence to inform policies aimed at integrating evidence-based mental health treatment in general medical settings. Proposed research of this award includes designing alternative payment and performance evaluation systems for depression care management in home health care and primary care, and assessing stakeholder acceptance of these incentive systems.
Economic Analysis of Rapid HIV and HCV Testing in Drug Abuse Treatment Programs
Bruce Schackman, PhD, PI
Jared Leff, MS, Huibo Shao, MS, MA, Study Staff
National Institutes of Health/National Institute on Drug Abuse
9/1/2009 – 8/31/2013
This study evaluates the cost and cost-effectiveness of HIV rapid testing and counseling in drug treatment programs alone and in combination with rapid HCV testing, using data from NIDA CTN Protocol 0032.
Enhanced Access to HIV Care for Drug Users in San Juan, Puerto Rico
Bruce Schackman, PhD, PI; Jared Leff, MS, Study Staff
National Institutes of Health/National Institute on Drug Abuse
3/1/2013 – 1/31/2018
The major goal of this project is to evaluate both the effectiveness and cost of implementation of a community-level structural approach to maximize outcomes along the implementation cascade of testing, linkage, ART initiation, engagement, and retention in care for HIV-positive injection drug users in Puerto Rico.
Genetics of Risk for Retinopathy Among Qataris with Type 2 Diabetes
Ronald Crystal, MD, Weill Cornell Medical College—New York (PI)
Abdulbari Bener, PhD, WCMC-Q (Co-Lead PI)
Maha El Shafei, MD, Hamad Medical Corporation (Co-PI)
Alvin Mushlin, MD, ScM, Weill Cornell Medical College—New York (Co-PI)
Donald D’Amico, MD, Weill Cornell Medical College—New York (Co-PI)
Hassan Ghomrawi, PhD, MPH, Weill Cornell Medical College—New York (Co-PI)
Szilard Kiss, MD, Weill Cornell Medical College—New York (Co-PI)
Qatar National Research Program’s (QNRF) National Priorities Research Fund (NPRP)
12/1/2010– 11/30/2013
The research team aims to zero in on genetic locations associated with diabetes and find loci associated specifically with diabetic retinopathy—the deterioration of the retina as a symptom of diabetes. Drawing on the most advanced genetic analysis approach, they will evaluate single nucleotide polymorphisms—differences in DNA base pairs that show up as a disruption in expected patterns—among a sample of Qatari subjects. This project is one part of a collaborative effort to analyze diabetes at the genetic level in Qatar.
Haiti AIDS Research Training: Models to Implementation
Jean Pape MD, PI; Bruce Schackman, PhD, Co-Investigator
4/1/09 – 3/31/14
The goal of Gheskio-Cornell ICOHRTA training program is to increase capacity in integrated clincial, operational, and health services research in support of Haiti’s national scale-up of HIV and tuberculosis services
Impact of Discordant Patient-Surgeon Expectations on Joint Arthroplasty Outcomes
Hassan Ghomrawi, PhD, MPH (PI)
National Institutes of Health/National Institute of Child Health and Human Development
2/3/2010 – 1/31/2014
The objective of this grant is to explore the extent and direction of discordance between the patient's and surgeon's expectations prior to total joint arthroplasty (TJA) surgery and its relationship to postoperative immediate, short-term and long-term outcomes. Findings from this study will help identify subpopulations of patients whose expectations may have a clinically meaningful effect on their outcomes, if they were discordant with those of their surgeons, and feed this information into targeted interventions such as the preoperative educational class so that expectations are realistically achievable. The study will use data from the joint replacement registry of the Weill Cornell Center for Education and Research on Therapeutics (CERT).
Integrated versus Separate Care for Hepatitis C, Substance Abuse and HIV Prevention
Ann Beeder, MD, PI of Subaward, Bruce Schackman, PhD, Stephen Ferrando, MD, Co-Investigators, Jared Leff, MS, Study Staff (In collaboration with Brian Edlin, MD, SUNY Downstate, PI)
National Institute on Drug Abuse/National Institutes of Health
4/1/2010-1/31/2015
The study will examine the feasibility, acceptability, safety, effectiveness, and cost of an Integrated Care Program for hepatitis C or HCV/HIV coinfection, addiction, and HIV prevention in active injection drug users (IDUs), in comparison with standard, separate treatment for each of these conditions.
Intensive Models of HCV Care for Injection Drug Users
Bruce Schackman, PhD, Subaward PI; Jared Leff, MS, Study Staff (In collaboration with Alain Litwin, MD, MPH, Albert Einstein College of Medicine, PI)
National Institutes of Health/National Institute on Drug Abuse
7/15/2012 – 6/30/2017
In this study patients from methadone clinics will be randomized to one of three models of hepatitis C care: directly observed therapy; concurrent group treatment; or standard on-site care. Dr. Schackman and Mr. Leff will oversee cost data collection and analyze the costs of delivering care in the study, and Dr. Schackman will contribute to the cost-effectiveness analysis design and implementation.
Modeling the Impact of HIV Prevention Interventions
Bruce Schackman, PhD, Subaward PI (In collaboration with George R. Seage, ScD, MPH, Harvard University School of Public Health, PI)
National Institutes of Health/National Institute of Mental Health
6/5/2010 – 3/31/14
Dr. Schackman’s role on this project will be to provide expertise in evaluating short- and long-term HIV prevention program costs using cost-effectiveness simulation modeling. He has extensive experience deriving cost and quality-of-life parameters for the CEPAC cost-effectiveness model, and in conducting costing studies of HIV interventions in the U.S. and in Haiti. As a member of the CEPAC Collaboration for over 10 years, he has established close working relationships with this project team. He will assume a leadership role overseeing cost parameter inputs into the HIV transmission model, including costs of HIV prevention interventions. He will also assist in conducting HIV prevention policy analyses, with a particular emphasis on prevention interventions among MSM in the U.S.
Pharmacogenomics of HIV Therapy
Bruce Schackman, PhD, Subaward PI (In collaboration with David W. Haas, MD,Vanderbilt University, PI)
National Institutes of Health/National Institute of Allergy and Infectious Diseases
07/01/2009 – 06/30/2013
The purpose of this study is to determine the utility of human pharmacogenomic testing for clinical HIV care through analyses of data and DNA from approximately 4500 participants from prospective, randomized clinical trials of the NIH-sponsored AIDS Clinical Trials Group (ACTG). Predictive models for response to antiretroviral therapies will be developed based on knowledge of human genetic variants. The primary responsibility of Dr. Schackman at Cornell will be to lead efforts in mathematical modeling of pharmacogenomics data in order to quantify the cost-effectiveness of human genetic testing to inform medication prescribing. This work may ultimately result in better individualized therapy (personalized medicine), and improved antiretroviral therapy treatment guidelines for persons living in resource-poor countries.
Quality of Life Outcomes in Prescription and Injection Opioid Dependence
Bruce Schackman, PhD, PI
Jared Leff, MS, Allison Dunning, MS, Study Staff
National Institutes of Health/National Institute on Drug Abuse
05/01/12 – 04/30/15
The purpose of this study is to measure quality of life in opioid dependence using primary data from a survey of the US population and secondary data from opioid dependent patients enrolled in three national studies. Our results will provide quality of life estimates and guidance for cost-effectiveness and comparative effectiveness studies of opioid dependence treatment. The study will also evaluate novel methodologies for assessing these outcomes.
Simulation Modeling to Improve HIV/HCV Screening, Treatment and Care
Bruce Schackman, PhD, Subaward PI (In collaboration with Benjamin Linas, PhD, Boston Medical Center, PI)
National Institutes of Health/National Institute on Drug Abuse
06/15/12 – 06/14/16
Dr. Schackman will contribute his extensive experience to the research effort, guiding the development of cost estimates for the model, and working closely with Dr. Linas on analyses of the impact of improved health services delivery on outcomes for HCV and HIV/HCV co-infected individuals.
Recent Grants
Development and Evaluation of a Web-Based Decision Aid for Screening Mammography
Elena Elkin, PhD, Margaret Polaneczky, MD, co-PIs
Alvin I. Mushlin, MD, ScM, Tessa Cigler, MD, (WCMC), Laura Liberman, MD (MSKCC), Co-Investigators
Weill Cornell CTSC/National Center for Research Resources/NIH
6/1/2010-5/31/2012
The grant will support the development and pilot evaluation of a web-based decision support tool to facilitate informed, shared decision-making for women in their 40s.
Chronic Pain Management Costs in a Multi-Institutional Patient Registry
Bruce Schackman, PhD, PI
Charles E. Inturrisi, PhD (WCMC), David A. Zylberger, MD (Weill Cornell-NYPH), Semih Gungor, MD (HSS), Paul A. Glare, MD (MSKCC), co-Investigators; Ashley Eggman, MS, Study Staff
Weill Cornell CTSC/National Center for Research Resources/NIH
6/1/2010-5/31/2012
This pilot study builds on a currently funded project that is establishing a multi-institutional registry of patients of pain clinics. The objective of the registry is to enable comparative effectiveness research of alternative pain management interventions. The pilot study will develop and implement methods to collect cost data for the registry. It will identify and collect data from multiple sources on the medical services utilized and costs of treating chronic pain patients. It will also use patient surveys to collect data on productivity costs of chronic pain.
Cost of an Evidence-Based Depression Care Management Intervention in Home Health and Payment Implications
Yuhua Bao, PhD, PI
National Institutes of Health/National Institute of Mental Health
6/15/2009 – 10/31/2011
Assesses the incremental cost to home health agencies of delivering an evidence-based depression quality improvement intervention to clinically depressed home health patients and related payment implications.
Evaluating the Link between HIV Prevention and Treatment
Bruce Schackman, PhD, Subaward PI (In collaboration with A. David Paltiel, PhD, Yale University, PI)
National Institutes of Health/National Institute of Mental Health
09/30/2008 – 09/30/2011
This project uses a mathematical simulation model to assemble and analyze the best available clinical and cost data in order to inform current policy debates, and to promote an evidence-based approach to HIV counseling, testing, and referral in the United States. Dr. Schackman will be responsible for overseeing policy analyses forecasting the budgetary impact of CDC HIV testing recommendations on public programs and will assist in conducting other HIV testing analyses.
HIV Testing and Counseling in STD Clinics: an Adaptation of CTN 0032
Bruce Schackman, PhD, Subaward PI; Ashley Eggman, MS, Study Staff(In collaboration with Lisa Metsch, PhD, University of Miami, Co-PI and Grant Colfax, MD, San Francisco Department of Public Health, Co-PI)
National Institutes of Health/National Institute on Drug Abuse
Stimulus Grant through the American Recovery and Reinvestment Act
9/30/2009 – 8/31/2011
The study, which will enroll 5,000 patients at high risk for HIV infection in nine sexually transmitted disease clinics in the United States, will determine whether receiving a rapid HIV test and counseling offers healthier outcomes than rapid testing alone. It will evaluate the effect of routine counseling at screening on the incidence of sexually transmitted infections as a primary outcome. Researchers will also measure reduction of risky sexual behaviors and substance use during sex after a six month period, as well as cost-effectiveness of counseling and testing.
http://www.nih.gov/news/health/nov2009/nida-19.htm
Health Policies to Improve Antidepressant Adherence Among Older Patients
Yuhua Bao, PhD, PI
Pfizer Scholars Grant in Health Policy
07/01/08 – 06/30/10
This project assessed the comparative effectiveness and cost-effectiveness of alternative pharmacy benefit policies to improve adherence to antidepressant medication.
