Prescription Drug Costs, Usage and Outcomes: Practical Insights From Research



harvard medical school: executive education
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Aaron Kesselheim M.D., J.D., M.P.H.

Associate Professor of Medicine
Harvard Medical School
Faculty Member, Division of Pharmacoepidemiology and Pharmacogenomics
Department of Medicine
Brigham and Women's Hospital

Aaron S. Kesselheim, M.D., J.D., M.P.H., is an Associate Professor of Medicine at Harvard Medical School and a faculty member in the Division of Pharmacoepidemiology and Pharmacoeconomics in the Department of Medicine at Brigham and Women's Hospital. He graduated from Harvard College and received his postgraduate training at the University of Pennsylvania School of Medicine and Law School, and most recently at the Harvard School of Public Health. He is Board Certified in Internal Medicine, and serves as a primary care physician at the Phyllis Jen Center for Primary Care at BWH. His research focuses on the effects of intellectual property laws and regulatory policies on pharmaceutical development, the drug approval process, and the costs, availability, and use of prescription drugs both domestically and in resource-poor settings. He has also investigated how other issues at the intersection of law and public health can affect the health care system, including health care fraud, expert testimony in malpractice cases, and insurance reimbursement practices. He is a member of the New York State Bar and is a Patent Attorney. Within the Division, Dr. Kesselheim leads the Program On Regulation, Therapeutics, And Law (PORTAL), an interdisciplinary research core focusing on intersections among prescription drugs and medical devices, patient health outcomes, and regulatory practices and the law. In 2013, Dr. Kesselheim was named a Greenwall Faculty Scholar in Bioethics by the Greenwall Foundation, which supports innovative empirical research in bioethics. Dr. Kesselheim's work is also currently funded by the FDA, Laura and John Arnold Foundation, and by a Robert Wood Johnson Investigator Award in Health Policy Research. In the past, he has received research support from the Edmond J. Safra Center for Ethics at Harvard University, AHRQ, Pew Charitable Trusts, and the Harvard Clinical and Translational Science Center.


Sarah K. Emond, MPP

Executive Vice President & Chief Operating Officer
Institute for Clinical and Economic Review, Boston, MA

With over 20 years of experience in the business and policy of health care, Sarah leads the strategic planning and operations of the Institute for Clinical and Economic Review, a leading non-profit health policy research organization, as Executive Vice President and Chief Operating Officer. In that role, she is responsible for overseeing ICER’s public programs, stakeholder engagement, operations, and finances. Prior to joining ICER, Sarah spent time as a communications consultant, with six years in the corporate communications and investor relations department at a commercial-stage biopharmaceutical company, and several years with a health care communications firm. Sarah began her health care career in clinical research at Beth Israel Deaconess Medical Center in Boston. A graduate of the Heller School for Social Policy and Management at Brandeis University, Sarah holds a Master of Public Policy degree with a concentration in health policy. Sarah also received a bachelor’s degree in biological sciences from Smith College. Sarah serves as the President of the Heller School Alumni Board, and is a past fellow of the Boston Chapter of the New Leaders Council. Sarah recently learned to ski and is proud that she hasn’t broken any bones doing so, and has completed seven half-marathons since she took up long-distance running in 2013.


Surya C. Singh, MD

Adjunct Instructor of Medicine, Harvard Medical School
Principal, Singh Health Advisers
Former Corporate Vice-President and Chief Medical Officer for Specialty, CVS
Caremark Corporation

As a senior advisor and consultant to non-profits, private corporations, and publicly traded companies, Dr. Singh provides expertise and guidance on healthcare issues with broad impact. While he frequently provides senior executives with counsel on their overall business strategy, he topically focuses on the adoption of novel therapies, acceleration of value-based reimbursement, predictive analytics and the use of artificial intelligence, and the clinical application of genomic sequencing. Previously, Dr. Singh was Corporate Vice-President and Chief Medical Officer at CVS Health Specialty, where he was responsible for specialty client & clinical strategy, product innovation, analytics, clinical program management, and drug safety/pharmacovigilance. In this role, he oversaw a multifaceted team of clinicians and analysts, led several strategic initiatives, partnerships, and acquisitions for the company, and played a key senior management role during a time of unprecedented business growth. Before CVS Health, Dr. Singh was Chief Medical Officer and Head of Product Development and Strategy at Proventys, (acquired by McKesson Corporation), Chief Medical Officer and SVP of Clinical Operations at D2Hawkeye (now part of Verisk Health) and was a healthcare strategy consultant at McKinsey and Company. Dr. Singh is licensed and board certified in internal medicine. He continues to care for patients as a Hospitalist at the Brigham and Women’s Hospital and is an Adjunct Instructor of Medicine at Harvard Medical School.


Michael S. Sherman, MD, MBA

Lecturer on Population Medicine, Harvard Medical School
Chief Medical Officer, Harvard Pilgrim Health Care

Dr. Michael Sherman serves as chief medical officer and senior vice president for health services for Harvard Pilgrim Health Care. A pioneer in developing outcomes-based payment agreements with pharmaceutical companies that go beyond the historical “pay for pill” approach and tie reimbursement to patient outcomes, he recently signed the first value-based agreement in the United States for a gene therapy used to treat a form of blindness. Dr. Sherman serves as chair of the Board of Managers of the Harvard Pilgrim Health Care Institute, which encompasses the Department of Population Medicine at Harvard Medical School and on the Advisory Board of the Institute for Clinical and Economic Review (ICER). He also is the current chair for AHIP’s CMO Leadership Council, comprising chief medical officers from health plans throughout the United States and serves on the board of directors for the Personalized Medicine Coalition. Prior to joining Harvard Pilgrim, Dr. Sherman held leadership roles at Humana, UnitedHealth Group, and Thomson Medstat (now IBM Truven). He holds a B.A. and an M.S. in biomedical anthropology from the University of Pennsylvania and received his M.D. from Yale and M.B.A. from the Harvard Business School.


Jerry Avorn, MD

Professor of Medicine, Harvard Medical School
Division Chief Emeritus, Division of Pharmacoepidemiology and Pharmacoeconomics,
Department of Medicine, Brigham and Women’s Hospital

Dr. Avorn is a professor of medicine at Harvard Medical School and chief
emeritus of the Division of Pharmacoepidemiology and Pharmacoeconomics in the Department of Medicine at the Brigham and Women’s Hospital in Bos- ton, one of Harvard’s main teaching institutions. His current work centers on documenting and improving physician medication use practices, defining the intended and adverse outcomes of prescription drugs as well as their cost-effectiveness, and studying the effects of medication-related policies in the private and public sectors. Dr. Avorn helped establish the Harvard program on aging, and his group was among the first to use large electronic datasets to identify prescribing patterns, medication use, and clinical outcomes. The 80-person interdisciplinary research division Dr. Avorn founded includes Harvard faculty from the disciplines of internal medicine, rheumatology, geriat- rics, anesthesiology, epidemiology, law, health policy, statistics, business and health economics. Dr. Avorn originated the “academic detailing” approach to improving medication use, providing unbiased drug information to clinicians through non-commercial educational outreach. He continues this work as the pro bono chief clinical consultant to Alosa Health, a Boston-based nonprofit that is the nation’s largest independent provider of academic detailing ser- vices and training. Dr. Avorn served as a member of the Institute of Medicine task force on evidence-based clinical guidelines, and is the author or co-author of over 550 papers and of the book, Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs (Knopf), now in its 11th printing. He has been named one of the most highly cited researchers in medicine and the social sciences for the last several years. Dr. Avorn earned a B.A. degree from Columbia and a M.D. degree from Harvard, and trained in internal medicine at its affiliated hospitals.


Michael A. Fischer, MD, MS

Associate Professor of Medicine
Harvard Medical School and Brigham and Women’s Hospital
Director
National Resource Center for Academic Detailing (NaRCAD)

Michael Fischer is a primary care physician at Brigham and Women’s Hospital and a researcher in the Division of Pharmacoepidemiology and Pharmacoeconomics. His research evaluates medication adherence; the appropriate use of prescription drugs; dissemination and implementation of evidence-based practices; prescription drug reimbursement policy; and the impact of electronic prescribing. He is the Director of the National Resource Center for Academic Detailing (www.NaRCAD.org), an initiative supported by the Agency for Health Care Research and Quality to assist organizations implementing interventions to improve health care quality and patient outcomes. Dr. Fischer earned his medical degree from the Yale School of Medicine and a Master of Science degree in health policy and management from the Harvard School of Public Health. He completed residency training in primary care internal medicine at Brigham and Women’s Hospital. He is an Associate Professor of Medicine at Harvard Medical School and of Epidemiology at the Harvard T.H. Chan School of Public Health.