BRIGHAM & WOMEN'S HOSPITAL DIVISION OF PHARMACOEPIDEMIOLOGY AND PHARMACOECONOMICS

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

The Division of Pharmacoepidemiology and Pharmacoeconomics seeks Fellows primarily interested in prescription drug use and policy. The Division features substantial expertise in pharmacoepidemiology and health services research methods and has a focus on studies related to evidence-based medication use, comparative safety and effectiveness evaluations, and access to care. Division faculty include members trained in internal medicine and pediatrics with additional training in medical specialties, epidemiology, and/or health services research; others have doctoral degrees in epidemiology and biostatistics. 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. 

The Division is led by Dr. Sebastian Schneeweiss. The Fellowship Program is led by Drs. Aaron S. Kesselheim and Benjamin N. Rome, who also help lead the interdisciplinary Program On Regulation, Therapeutics, And Law (PORTAL) based in the Division. Clinical specialties represented on our faculty include general internal medicine and primary care, pediatrics, pulmonary/critical care, preventive medicine, geriatrics, and hospital medicine. Trainees will also be able to work with expert faculty members in health policy research, law, implementation science, ethics, 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. With growing recognition of the importance of rigorous assessment of medication risks and benefits, Division faculty have become an integral part of the FDA’s Sentinel drug safety surveillance system under the leadership of Dr. Rishi Desai. Research relationships have also been established 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: 

·         Medication use, comorbidity, and outcomes in aging populations 

·         Evaluating patient non-adherence and improving adherence with novel interventions

·         Advanced methodological approaches to controlling for confounding in observational studies of

          medication safety and effectiveness.

·         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, including an affiliation with the provider of the nation’s largest academic detailing resource

·         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 development, regulatory approval, and availability 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.