A team of Yale researchers will play a major role in a new, five-year federally funded project that will address the cost- effectiveness of programs designed to halt the spread of HIV, the virus that causes AIDS.
A novel component of the project will be its reliance on techniques from operations research, statistics and economics to create mathematical models of the impact of HIV prevention programs, according to Edward Kaplan, professor of management sciences and medicine at the School of Management SOM and a lead scientist on the project. He will collaborate with David Paltiel, assistant professor of health policy and management in the department of epidemiology and public health, and other Yale faculty, as well as colleagues at two other universities.
According to Professor Kaplan, "Decisions regarding how much money to spend on HIV prevention programs are made haphazardly. Most prevention programs are not evaluated at all, those that are studied typically do not involve serious attempts to estimate the number of new infections prevented, and precious few studies report the actual costs of intervening. Yet, given that the goal of HIV prevention is, in fact, to prevent HIV infections, one would think that a wiser approach would be to figure out how prevention dollars can be spent more effectively."
Professor Paltiel says: "Our study aims to promote more reasoned decision-making in the realm of AIDS and drug abuse policy. We propose to develop economic and mathematical models for evaluating interventions to inform the allocation of scarce societal resources. This is the bottom line of our research -- to figure out how society can gain the most from its HIV prevention dollars."
The researchers' combined efforts to track the effectiveness of public-health programs to stop the spread of AIDS are being funded by a $3.5 million grant that the National Institute on Drug Abuse and the National Institutes of Health awarded to a New Canaan, Connecticut-based research institute, the Societal Institute of the Mathematical Sciences. SIMS will provide administrative support for the entire project.
Donald L. Thomsen Jr., SIMS founder and president, says that the teams of researchers will work in close cooperation. "Having teams carry on this research effort cooperatively will have a multiplicative effect which will produce more valuable results than would be possible if the same centers carried out their research in relative isolation," he adds.
Professor Kaplan is noted for his earlier applications of operations research to the design and evaluation of HIV interventions, most notably the New Haven Needle Exchange Program. His research has figured prominently in recent reports issued by the National Academy of Sciences, Institute of Medicine, Centers for Disease Control and Prevention, and the General Accounting Office.
Professor Paltiel, who received his Ph.D. in operations research from Yale in 1992, recently returned to the University after serving for four years on the Harvard School of Public Health faculty. An expert in the economic evaluation of health programs in general and cost-effectiveness analysis in particular, he has consulted for the U. S. Agency for Health Care Policy and Research, the Substance Abuse and Mental Health Services Administration, and the National Institute on Mental Health.
Other Yale investigators participating in the study are Dr. Michael Merson, dean of public health and chair of the department of epidemiology and public health, and Harold Pollack, a Robert Wood Johnson Health Policy Scholar and a lecturer at SOM. In conducting this study, they will also join Margaret Brandeau and Dr. Douglas Owens of Stanford University and Dr. James Kahn of the University of California at San Francisco.