©2019 by Harvard Medical School Fellowship in General Medicine and Primary Care

Brigham and Women's Hospital - Pharmacoepidemiology and Pharmoeconomics

Brigham and Women’s Hospital
Division of Pharmacoepidemiology and Pharmacoeconomics
1620 Tremont Street
Boston, MA 02120

 

Fellows will be given skills to generate and synthesize evidence on the effectiveness of medical interventions (drugs, devices, vaccines, procedures, diagnostics, etc.) that will lead to better-informed clinical decisions.

Clinical specialties represented on our faculty include general internal medicine and primary care, nephrology, rheumatology, geriatrics, and hospital medicine. Trainees will also be able to work with expert faculty members in health policy research, law, history, computer science, decision science, cost-effectiveness analysis, and clinical pharmacy. The Division has a rich infrastructure, including multiple populations-based insurance databases, experienced programmer-analysts, and dedicated research assistants that make possible implementation of a wide variety of research protocols.

The work of the Division centers on rigorously defining the relationships among the benefits, risks, and costs of medications, and on studying the effect of each of these on healthcare. In the last several years, the Division has become one of the most active programs in the nation that performs research on medication outcomes, adverse effects, and cost-effectiveness. In 2005, under Dr. Schneeweiss’s leadership, the Division was named a “DEcIDE Center” (Developing Evidence to Inform Decisions about Effectiveness), part of a federally funded network to advise the government about the comparative efficacy and safety of medical therapies. The Division was further selected to become the nation’s only DEcIDE Methods Center. The new Center is performing original research on methodological issues in CER, convening methods symposia, establishing a learning network, and developing national best practice recommendations for CER. With growing recognition of the importance of more rigorous definition of medication risks and benefits, Division faculty have become an integral part of the FDA’s new Sentinel drug safety surveillance system. We have also established ongoing research relationships with one of the nation’s largest health insurers and with a large national pharmacy chain to use their data to study patterns of drug use and outcomes. Research relationships have also been established or strengthened with the Dana-Farber Cancer Institute, the Harvard Faculty of Arts and Sciences, and the Harvard T.H. Chan School of Public Health.

Currently funded studies focus on the quantification of the efficacy, risks, and costs of specific medications or medication classes; documentation of patterns of drug use by physicians and patients; and programs to improve the appropriateness of medication use. Some examples include:

  • Comparative effectiveness of carotid stents vs. carotid endarterectomy and implantable cardioverter-defibrillators vs. medical management

  • Medication use, comorbidity, and outcomes in aging populations

  • Improving patient non-adherence with prescribed regimens

  • Advanced methodological approaches to controlling for confounding in observational studies of drug risks

  • A national academic detailing resource to adapt and disseminate CER findings

  • Analyzing complex healthcare data to determine causality of observed drug effects

  • Efficacy versus effectiveness of new strategies for decreasing cancer mortality

  • Clinical and economic consequences of changes in drug reimbursement policies

  • Designing, implementing, and evaluating innovative programs to improve physician prescribing practices

  • Comparative effectiveness methods for evaluation of in-hospital exposures

 

Our faculty is engaged in a wide range of research related to the evaluation of the comparative benefits, risks, and cost-effectiveness of medical interventions in routine care settings and the effectiveness of health care delivery systems and interventions to improve prescribing practices and medication adherence. Other active research areas include legal analyses of the distribution, use and intellectual property issues of medications, conflict of interest policies and physician interpretation of biomedical science, and the development and testing of new methodologies for non-randomized research of treatment effects.

The Division of Pharmacoepidemiology and Pharmacoeconomics’ Fellowship is located in the Department of Medicine at Brigham and Women’s Hospital, within walking distance to the Harvard Medical School, the Harvard T.H. Chan School of Public Health, and public transportation. Fellows sit at the main Division offices at 1620 Tremont Street, which is at Brigham Circle diagonal from the historic Peter Bent Brigham entrance to Brigham and Women’s Hospital.