2024
Strategies for isoniazid preventive therapy in HIV-positive patients who consume alcohol.
Savinkina A, Muyindike W, Hahn J, Emenyonu N, Fatch R, Ngabirano C, Adong J, Jacobson K, Linas B. Strategies for isoniazid preventive therapy in HIV-positive patients who consume alcohol. The International Journal Of Tuberculosis And Lung Disease 2024, 28: 335-342. PMID: 38961548, DOI: 10.5588/ijtld.23.0303.Peer-Reviewed Original ResearchConceptsIsoniazid preventive therapyTB preventive therapyTuberculin skin testPreventive therapyReport alcohol useAlcohol useHIV-positive patientsTB disease incidenceLiver enzyme monitoringLatent TB infectionTB burden settingsSkin testTB infectionBurden settingsConsuming alcoholTB diseaseTB riskWHO guidanceTherapyEnzyme monitoringPLWHIsoniazidEvaluate hepatotoxicityHepatotoxicity concernsAST/ALT
2023
Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study
Savinkina A, Jurecka C, Gonsalves G, Barocas J. Mortality, incarceration and cost implications of fentanyl felonization laws: A modeling study. International Journal Of Drug Policy 2023, 121: 104175. PMID: 37729682, PMCID: PMC10840895, DOI: 10.1016/j.drugpo.2023.104175.Peer-Reviewed Original ResearchEconomic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder
Flam-Ross J, Marsh E, Weitz M, Savinkina A, Schackman B, Wang J, Madushani R, Morgan J, Barocas J, Walley A, Chrysanthopoulou S, Linas B, Assoumou S. Economic Evaluation of Extended-Release Buprenorphine for Persons With Opioid Use Disorder. JAMA Network Open 2023, 6: e2329583. PMID: 37703018, PMCID: PMC10500382, DOI: 10.1001/jamanetworkopen.2023.29583.Peer-Reviewed Original ResearchConceptsExtended-release buprenorphineIncremental cost-effectiveness ratioMedication treatmentHealth care utilization costsTreatment of OUDOpioid agonist treatmentOpioid use disorderMean lifetime costsCost-effectiveness ratioProbabilistic sensitivity analysesEconomic evaluationCohort studyAgonist treatmentTreatment optionsClinical trialsClosed cohortMAIN OUTCOMEBuprenorphineSimulated cohortUse disordersDrug AdministrationUS FoodPharmaceutical costsQALY willingnessInjectable formPopulation-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities
Barocas J, Nall S, Axelrath S, Pladsen C, Boyer A, Kral A, Meehan A, Savinkina A, Peery D, Bien M, Agnew-Brune C, Goldshear J, Chiang J, Linas B, Gonsalves G, Bluthenthal R, Mosites E, Wortley P, Todd J, Melton D, Flynn C, German D, Klevens M, Doherty R, O'Cleirigh C, Jimenez A, Clyde T, Poe J, Vaaler M, Deng J, Al-Tayyib A, Shodell D, Higgins E, Griffin V, Sanger C, Khuwaja S, Lopez Z, Padgett P, Kwa Sey E, Ma Y, Santacruz H, Brantley M, Mathews C, Marr J, Spencer E, Nixon W, Forrest D, Anderson B, Tate A, Abrego M, Robinson W, Barak N, Beckford J, Braunstein S, Rivera A, Carrillo S, Ibrahim A, Wogayehu A, Moraga L, Brady K, Shinefeld J, Nnumolu C, Menza T, Orellana E, Bhattari A, Flynn A, Chambers O, Ramos M, McFarland W, Lin J, Miller D, Miranda De Leon S, Rolon-Colon Y, Martinez M, Jaenicke T, Glick S, Kienzle J, Smith B, Reid T, Opoku J, Kuo I, Adams M, Baugher A, Broz D, Burnett J, Chambers S, Chapin-Bardales J, Denning P, Finlayson T, Handanagic S, Hickey T, Kanny D, Lee K, Lewis R, Morris E, Olansky E, Robbins T, Sionean C, Smith A, Teplinskaya A, Trujillo K, Wejnert C, Whiteman A, Xia M. Population-Level Health Effects of Involuntary Displacement of People Experiencing Unsheltered Homelessness Who Inject Drugs in US Cities. JAMA 2023, 329: 1478-1486. PMID: 37036716, PMCID: PMC10087093, DOI: 10.1001/jama.2023.4800.Peer-Reviewed Original ResearchConceptsNational HIV Behavioral Surveillance SystemInitiation of medicationInjection-related infectionsOpioid use disorderUse disordersHealth effectsInjection drug useLong-term health effectsDrug-related morbidityPopulation attributable fractionBehavioral Surveillance SystemSubstance use disordersMAIN OUTCOMEOverdose deathsRepresentative cohortAdditional deathsOverdose mortalityHealth outcomesDrug useNatural historyDisease controlMortalityDisorder outcomesDrugsHealth implicationsEstimated Clinical Outcomes and Cost-effectiveness Associated With Provision of Addiction Treatment in US Primary Care Clinics
Jawa R, Tin Y, Nall S, Calcaterra S, Savinkina A, Marks L, Kimmel S, Linas B, Barocas J. Estimated Clinical Outcomes and Cost-effectiveness Associated With Provision of Addiction Treatment in US Primary Care Clinics. JAMA Network Open 2023, 6: e237888. PMID: 37043198, PMCID: PMC10098970, DOI: 10.1001/jamanetworkopen.2023.7888.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioPrimary care practitionersClinical outcomesPCP servicesPrimary careAddiction servicesAddiction careUS primary care clinicsLong-term clinical outcomesHealth care sector costsInjection-related infectionsPrimary care clinicsHealth care sector perspectivePrimary care practicesCost-effectiveness ratioObservational cohortBuprenorphine prescribingCare clinicsClinical trialsPCP practicesTreatment strategiesMAIN OUTCOMESimulated cohortCare practitionersCare practicesEstimated Costs and Outcomes Associated With Use and Nonuse of Medications for Opioid Use Disorder During Incarceration and at Release in Massachusetts
Chatterjee A, Weitz M, Savinkina A, Macmadu A, Madushani R, Potee R, Ryan D, Murphy S, Walley A, Linas B. Estimated Costs and Outcomes Associated With Use and Nonuse of Medications for Opioid Use Disorder During Incarceration and at Release in Massachusetts. JAMA Network Open 2023, 6: e237036. PMID: 37058306, PMCID: PMC10105308, DOI: 10.1001/jamanetworkopen.2023.7036.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioIncremental costCost-effectiveness ratioEconomic evaluationEconomic studiesOpioid use disorderXR-naltrexoneOverdose deathsTreatment startQALYOverdose mortalityUse disordersCostExtended-release naltrexoneTreatment costsDiscontinue medicationsMOUD accessQALYsOpen cohortMost prisonsIncarcerated individualsMOUD treatmentTreatment strategiesMoneyFatal overdosesKeep it up! 3.0: Study protocol for a type III hybrid implementation-effectiveness cluster-randomized trial
Mustanski B, Saber R, Jones J, Macapagal K, Benbow N, Li D, Brown C, Janulis P, Smith J, Marsh E, Schackman B, Linas B, Madkins K, Swann G, Dean A, Bettin E, Savinkina A. Keep it up! 3.0: Study protocol for a type III hybrid implementation-effectiveness cluster-randomized trial. Contemporary Clinical Trials 2023, 127: 107134. PMID: 36842763, PMCID: PMC10249332, DOI: 10.1016/j.cct.2023.107134.Peer-Reviewed Original ResearchConceptsHIV riskHybrid effectiveness-implementation clusterCommunity-based organizationsPublic health scaleCluster-randomized trialHIV prevention programsRE-AIM modelHealth technology interventionStudy protocolOutcome measurementsCBO staffHealth ScalePrevention programsEHealth approachesConsolidated FrameworkIntervention implementationTrialsImplementation researchKIUImplementation outcomesYoung menCounty-level population estimatesYMSMConsumer recruitmentMenPlanning for Mpox on a College Campus: A Model-Based Decision-Support Tool.
Savinkina A, Chitwood M, Kwon J, Pitzer V, Gonsalves G, Paltiel A. Planning for Mpox on a College Campus: A Model-Based Decision-Support Tool. Annals Of Internal Medicine 2023, 176: 340-347. PMID: 36716454, PMCID: PMC10338074, DOI: 10.7326/m22-2734.Peer-Reviewed Original ResearchConceptsSustained transmissionNational InstituteLow-risk groupHigh-risk populationPopulation of MSMHealth-National InstituteResidential college campusSymptomatic casesHypothetical cohortCongregate settingsStudy populationPreemptive vaccinationReactive vaccinationInfectious diseasesVaccinationDrug abuseBasic reproductive numberFuture outbreaksFrequent physical contactMSMReproductive numberOutbreakDaysMenTimely detectionEstimated Testing, Tracing, and Vaccination Targets for Containment of the US Mpox Outbreak
Chitwood M, Kwon J, Savinkina A, Walker J, Bilinski A, Gonsalves G. Estimated Testing, Tracing, and Vaccination Targets for Containment of the US Mpox Outbreak. JAMA Network Open 2023, 6: e2250984. PMID: 36637825, PMCID: PMC9857202, DOI: 10.1001/jamanetworkopen.2022.50984.Peer-Reviewed Original Research
2022
Population-Level Strategies for Nirmatrelvir/Ritonavir Prescribing—A Cost-effectiveness Analysis
Savinkina A, Paltiel A, Ross J, Gonsalves G. Population-Level Strategies for Nirmatrelvir/Ritonavir Prescribing—A Cost-effectiveness Analysis. Open Forum Infectious Diseases 2022, 9: ofac637. PMID: 36589482, PMCID: PMC9792084, DOI: 10.1093/ofid/ofac637.Peer-Reviewed Original ResearchCost-effectiveness analysisTrade-offs implicitSevere diseaseDecision analytic modelAllocation decisionsPay thresholdsPolicy strategiesUnvaccinated patientsVaccination statusHigh riskTreatment effectivenessHigh-risk individualsAllocation strategyPopulation-level strategiesWillingnessFurther priorityDrug costsSensitivity analysisCostRitonavir treatmentUnvaccinated personsVaccinated adultsPatient populationClinical trialsLower riskEstimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study
Savinkina A, Bilinski A, Fitzpatrick M, Paltiel AD, Rizvi Z, Salomon J, Thornhill T, Gonsalves G. Estimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study. BMJ Open 2022, 12: e061752. PMID: 36100306, PMCID: PMC9471205, DOI: 10.1136/bmjopen-2022-061752.Peer-Reviewed Original ResearchConceptsLow-income countriesIncome countriesDeath avertedHigh-income nationsStatistical lifeAvertable deathsIncome nationsCOVID-19 deathsReasonable investmentHigh costKey inputCountriesParameter estimatesAvertedCostSensitivity analysisUniversal vaccinationGlobal vaccinationMRNA COVID-19 vaccinationNationsInvestmentPrimary vaccine seriesLow vaccine effectivenessCOVID-19 vaccinationPublic dataPopulation‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis
Savinkina A, Madushani RWMA, Yazdi G, Wang J, Barocas JA, Morgan JR, Assoumou SA, Walley AY, Linas BP, Murphy SM. Population‐level impact of initiating pharmacotherapy and linking to care people with opioid use disorder at inpatient medically managed withdrawal programs: an effectiveness and cost‐effectiveness analysis. Addiction 2022, 117: 2450-2461. PMID: 35315162, PMCID: PMC9377514, DOI: 10.1111/add.15879.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioOpioid use disorderStandard of careUse disordersFatal overdosesDetox patientsMOUD initiationWithdrawal programInitiation of medicationHealth care sector perspectiveRisk of overdoseFatal opioid overdosesCost-effectiveness ratioCost-effectiveness analysisOpioid useHealth care spendingOutpatient careDetox programsOpioid overdosesMOUDPatientsOverdosesPopulation-level impactDisorder populationHealth effectsModeling the cost‐effectiveness and impact on fatal overdose and initiation of buprenorphine–naloxone treatment at syringe service programs
Adams JW, Savinkina A, Fox A, Behrends CN, Madushani RWMA, Wang J, Chatterjee A, Walley AY, Barocas JA, Linas BP. Modeling the cost‐effectiveness and impact on fatal overdose and initiation of buprenorphine–naloxone treatment at syringe service programs. Addiction 2022, 117: 2635-2648. PMID: 35315148, PMCID: PMC9951221, DOI: 10.1111/add.15883.Peer-Reviewed Original ResearchConceptsSyringe services programFatal opioid overdosesBuprenorphine-naloxone treatmentOpioid use disorderTreatment initiationBuprenorphine treatmentOpioid overdosesFatal overdosesSSP clientsActive opioid useCommunity treatment providersObservational cohort studyNational surveillance dataCost-effectiveness analysisCohort studyIntervention scenariosOpioid useBuprenorphine programOUD treatmentStatus quo scenarioClinical trialsFatal overdoseMore QALYsUse disordersTreatment engagementDetermining the lower limit of detection required for HCV viral load assay for test of cure following direct‐acting antiviral‐based treatment regimens: Evidence from a global data set
Morgan JR, Marsh E, Savinkina A, Shilton S, Shadaker S, Tsertsvadze T, Kamkamidze G, Alkhazashvili M, Morgan T, Belperio P, Backus L, Doss W, Esmat G, Hassany M, Elsharkawy A, Elakel W, Mehrez M, Foster GR, Kinge C, Chew KW, Chasela CS, Sanne IM, Thanung YM, Loarec A, Aslam K, Balkan S, Easterbrook PJ, Linas BP. Determining the lower limit of detection required for HCV viral load assay for test of cure following direct‐acting antiviral‐based treatment regimens: Evidence from a global data set. Journal Of Viral Hepatitis 2022, 29: 474-486. PMID: 35278339, PMCID: PMC9248016, DOI: 10.1111/jvh.13672.Peer-Reviewed Original ResearchConceptsDetectable viraemiaDetectable HCV RNALow-level viraemiaVirological treatment failureHCV viral loadTest of cureHepatitis C virusViral load assaysHCV viraemiaHCV RNATreatment failureViral loadC virusClinical trialsMinimal fibrosisSVR12ViraemiaGlobal eliminationLogistic regressionDiagnostic performanceLevel of detectionObservational databaseIULaboratory-based assaysCureSimulated Cost-effectiveness and Long-term Clinical Outcomes of Addiction Care and Antibiotic Therapy Strategies for Patients With Injection Drug Use–Associated Infective Endocarditis
Adams JW, Savinkina A, Hudspeth JC, Gai MJ, Jawa R, Marks LR, Linas BP, Hill A, Flood J, Kimmel S, Barocas JA. Simulated Cost-effectiveness and Long-term Clinical Outcomes of Addiction Care and Antibiotic Therapy Strategies for Patients With Injection Drug Use–Associated Infective Endocarditis. JAMA Network Open 2022, 5: e220541. PMID: 35226078, PMCID: PMC8886538, DOI: 10.1001/jamanetworkopen.2022.0541.Peer-Reviewed Original ResearchConceptsOutpatient parenteral antimicrobial therapyIncremental cost-effectiveness ratioOral antibiotic therapyInjection drug use-associated infective endocarditisUsual care strategyAntibiotic therapyOpioid drug useAntibiotic treatment strategiesAntibiotic strategiesCare servicesTreatment strategiesCare strategiesTreatment discontinuationClinical outcomesInfective endocarditisDrug use-associated infective endocarditisDrug useInpatient intravenous antibiotic therapyLong-term clinical outcomesHigher treatment completion rateIntravenous antibiotic therapyObservational cohort studyPercentage of patientsPostacute care facilityParenteral antimicrobial therapy
2021
Clinical impact, costs, and cost-effectiveness of hospital-based strategies for addressing the US opioid epidemic: a modelling study
Barocas JA, Savinkina A, Adams J, Jawa R, Weinstein ZM, Samet JH, Linas BP. Clinical impact, costs, and cost-effectiveness of hospital-based strategies for addressing the US opioid epidemic: a modelling study. The Lancet Public Health 2021, 7: e56-e64. PMID: 34861189, PMCID: PMC8756295, DOI: 10.1016/s2468-2667(21)00248-6.Peer-Reviewed Original ResearchConceptsOpioid use disorderAddiction consult serviceHospital-based strategiesUS opioid epidemicOpioid epidemicUse disordersConsult serviceProbabilistic sensitivity analysesClinical impactDrug useIncremental cost-effectiveness ratioInjection-related infectionsInjection drug useMean lifetime costsNational InstituteCost-effectiveness ratioHarm reduction servicesDeterministic sensitivity analysesInpatient prescribingObservational cohortRecurrent infectionsOutpatient treatmentClinical trialsOverdose riskMedicationsProjected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study
Barocas JA, Savinkina A, Lodi S, Epstein RL, Bouton TC, Sperring H, Hsu HE, Jacobson KR, Schechter-Perkins EM, Linas BP, White LF. Projected Long-Term Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Hepatitis C Outcomes in the United States: A Modeling Study. Clinical Infectious Diseases 2021, 75: e1112-e1119. PMID: 34499124, PMCID: PMC8522427, DOI: 10.1093/cid/ciab779.Peer-Reviewed Original ResearchConceptsLiver-related deathPre-pandemic levelsHepatitis C outcomesCoronavirus disease 2019 (COVID-19) pandemicCOVID-19-related disruptionsPre-pandemic ratesDisease 2019 pandemicHCV careHCV outcomesVirologic responseHCV epidemicTreatment initiationPandemic-related disruptionsCare disruptionsC outcomesAdditional casesCare servicesCare deliveryCirrhosisHCVHealthcare deliveryCOVID-19COVID-19 pandemicAggressive effortsOutcomesHCV Viral Load Greater Than 1000 IU/ml at Time of Virologic Failure in Direct-Acting Antiviral-Treated Patients
Morgan JR, Savinkina A, Pires dos Santos AG, Xue Z, Shilton S, Linas B. HCV Viral Load Greater Than 1000 IU/ml at Time of Virologic Failure in Direct-Acting Antiviral-Treated Patients. Advances In Therapy 2021, 38: 1690-1700. PMID: 33590445, PMCID: PMC7932931, DOI: 10.1007/s12325-021-01647-4.Peer-Reviewed Original ResearchConceptsMean HCV RNA levelHCV RNA levelsVirologic failureIU/HCV RNARNA levelsPost-treatment week 4Hepatitis C cureMean HCV RNATreatment virologic failureLevel of viremiaDirect acting antiviralsHCV viral loadTime of relapseResource-limited settingsTreatment failureViral loadElimination targetsClinical trialsWeek 4PatientsCare testOverall populationCare assaysLarger studyProjected Estimates of Opioid Mortality After Community-Level Interventions
Linas BP, Savinkina A, Madushani RWMA, Wang J, Yazdi G, Chatterjee A, Walley AY, Morgan JR, Epstein RL, Assoumou SA, Murphy SM, Schackman BR, Chrysanthopoulou SA, White LF, Barocas JA. Projected Estimates of Opioid Mortality After Community-Level Interventions. JAMA Network Open 2021, 4: e2037259. PMID: 33587136, PMCID: PMC7885041, DOI: 10.1001/jamanetworkopen.2020.37259.Peer-Reviewed Original ResearchConceptsCommunity-level interventionsOverdose mortalityOpioid overdoseUse of MOUDDistribution of naloxoneOpioid overdose deathsDecision analytical modelOpioid overdose ratesMOUD retentionOUD populationOpioid mortalityMAIN OUTCOMEMOUDNaloxone distributionOverdose deathsOverdose ratesSingle interventionMortalityNaloxoneInterventionMonthsOverdoseProjected estimatesHuman ServicesOutcomes
2020
A clash of epidemics: Impact of the COVID-19 pandemic response on opioid overdose
Linas BP, Savinkina A, Barbosa C, Mueller PP, Cerdá M, Keyes K, Chhatwal J. A clash of epidemics: Impact of the COVID-19 pandemic response on opioid overdose. Journal Of Substance Use And Addiction Treatment 2020, 120: 108158. PMID: 33298298, PMCID: PMC7536128, DOI: 10.1016/j.jsat.2020.108158.Peer-Reviewed Original ResearchConceptsOpioid use disorderCOVID-19 infectionCoronavirus disease 2019COVID-19Treatment-seeking behaviorPhysical distancingCOVID-19 pandemic responseOpioid epidemicDisease 2019Overdose mortalityUse disordersGreater substance usePhysical distancing interventionsMental healthQuarantine interventionSubstance useDrug supplyPandemic responsePublic healthHealthInterventionEpidemicDirect effectPossible mechanismOpioids