UConn experts joining CHERISH, a multi-institutional Center of Excellence funded by the National Institute on Drug Abuse, are Linda Sprague Martinez, Ph.D. and Gillian Betz, MPH
UConn Health Disparities Institute is sharing its expertise with CHERISH. HDI's Linda Sprague Martinez and Gillian Betz have both been selected as new members of the national Center of Excellence funded by NIDA.
The National Institute on Drug Abuse (NIDA) has renewed CHERISH as a national Center of Excellence, awarding the center $10.9 million over five years to address the epidemics of substance use disorder (SUD), hepatitis C virus (HCV), and HIV.
The multi-institutional Center of Excellence CHERISH (The Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV) develops and disseminates health economic research to inform substance use disorder treatment policy and HCV and HIV care of people who use drugs.
The syndemic of SUD, HCV, and HIV cannot be ignored. In the U.S., despite advances in medication and treatment options, the combined impact of SUD, HCV, and HIV contribute to over 80,000 overdose deaths yearly and new HCV and HIV outbreaks associated with drug use. Additionally, SUD treatment and HCV/HIV management require long-term engagement and financial investment. However, limited financial resources force healthcare leaders, public and private sector decision makers, and health systems to pay attention to how they allocate funds. The arrival and distribution of opioid settlement funds also motivate healthcare leaders to identify priority areas and initiatives they want to sustain.
The economic burden of the syndemic of SUD, HCV, and HIV is significant. SUD alone is estimated to cost more than $700 billion per year in the U.S.
"As financial resources tighten across the U.S., evaluating the cost and cost-effectiveness of interventions and informing resource allocation processes grow in importance," said Bruce Schackman, CHERISH director.
CHERISH is continuing to strengthen its foundational research partnerships across Weill Cornell Medicine, Boston Medical Center, Boston University School of Public Health, University of Pennsylvania, and University of Miami Miller School of Medicine and has welcomed new colleagues.
Joining CHERISH from the UConn Health Disparities Institute are both Linda Sprague Martinez and Gillian Betz who will bring expertise in Delphi implementation methods and assist the CHERISH Population Data & Modeling Core with identifying population-level variables.
"We will bring expertise to CHERISH related to health disparities and the social determinants of health," says Dr. Linda Sprague Martinez, director of the UConn Health Disparities Institute. "I am excited about the opportunity to contribute to the CHERISH mission. The Health Disparities Institute will implement consensus building techniques that will enhance the work of the Population Data Modeling Core by identifying meaningful population level variables."
"Collaboration is key to advancing health equity, and the way we collaborate matters just as much," shares Gillian Betz, MPH, CHSE of the UConn Health Disparities Institute. "I am thrilled to be part of the Population Data Modeling Core, a multidisciplinary team using population-level data to identify strategies that improve care for people who use substances and challenge stigma"
Betz of UConn adds, "At HDI, we bring an equity lens that enhances these data-driven approaches by centering the needs and lived experiences of community members. Through this partnership, we will cultivate a co-learning, equity-driven environment that uplifts the justice-aligned goals of CHERISH."
In addition, new colleagues lending their expertise to CHERISH include Weill Cornell Medicine, Ali Jalali will serve as the CHERISH Methodology Core co-director and bring his expertise in advanced econometric and statistical methods; Jonathan Purtle from New York University and Julia Hinckley, Karl Stark, and M Davis from the University of Pennsylvania will enhance the CHERISH Dissemination & Policy Core through policy engagement strategies and implementation science research.
"Our combined expertise as health economists, simulation modelers, clinician researchers, dissemination scientists, and policy experts play synergistic roles in sharpening our data collection and analysis, and the dissemination of findings about the care of people with SUD, HCV, and HIV," said Benjamin Linas, who will direct the CHERISH Population Data & Modeling Core with Jake Morgan, the newly appointed core co-director, with the support of Dimitri Baptiste and Hana Zwick from the Syndemics Lab.
To support decisions about embracing new approaches, CHERISH assists researchers in considering both clinical and economic outcomes.
"Economic evaluations can provide a holistic view of an intervention's costs and benefits, from multiple decision-maker perspectives," said Sean Murphy, who will newly serve as the CHERISH co-director. "SUD interventions can be costly from a payer's perspective, which is why it is critical that it is viewed alongside relevant downstream cost-offsets and non-financial benefits, such as improved quality-of-life," Murphy explained.
In the new cycle, CHERISH will develop research to support the financial sustainability of SUD interventions, advance research methodologies, and accelerate the knowledge translation and exchange of information between researchers and decision makers.
The next five years build on previous grant cycles where CHERISH led research to inform the integration of substance use treatment into systems of care and captured the economic and clinical impact of SUD and HCV/HIV interventions at the individual-, system-, and community-level.
Assembling Early-career Researchers and State Decision Makers
Responding to the rapidly changing SUD and related HCV/HIV landscape requires extensive collaboration between clinical and health economics researchers, ongoing communication with decision makers, and career mentorship within the field.
"There's only a small pool of researchers that has the requisite training and expertise to conduct cross-disciplinary health economics research," said Yuhua Bao, who will serve as the new CHERISH Pilot Grant, Training & Mentoring Core director. "This pool is only going to dwindle unless we make deliberate efforts in training and mentoring," Bao added. To address the gap, CHERISH will continue to provide support through pilot grant awards, health economics methods training, and targeted mentoring, and will build connections through the CHERISH Research Affiliates program, a national network of SUD economics and health services research experts.
To turn evidence into practice, CHERISH will host seminars to facilitate critical conversations with leaders at the federal, state, and local level. "Maintaining channels for constructive dialogue will be critical as both the syndemic and the financing mechanisms for health care evolve," said Zachery Meisel, CHERISH Dissemination & Policy Core director.
CHERISH Looking Ahead
"Budget changes or constraints often stand in the way of implementing or sustaining evidence-based practices," said Kathryn McCollister, the CHERISH Methodology Core director. "In our newest chapter of CHERISH, we're eager to share our expertise with other researchers so they can leverage our tools and methodologies to relay the full impact of investing in SUD, HCV, and HIV health interventions," McCollister said.
