The Division of Pharmacoepidemiology & Pharmacoeconomics at the Brigham and Women’s Hospital includes faculty and staff with backgrounds in internal medicine and its subspecialties, as well as epidemiology, health services research and policy, geriatrics, biostatistics, decision science, and public health. Major areas of research include: the scientific, policy, and social factors that influence physicians’ drug choices; medication compliance by patients; the identification and prevention of adverse drug effects; programs to improve the appropriateness of prescribing and drug taking; and pharmaceutical cost-effectiveness analysis.

The Division carries forward the research agenda of the Program for Analysis of Clinical Strategies, initially begun by Dr. Avorn in 1979. Currently active research projects are designed to address questions such as the following:

  • What effects do different non-steroidal anti-inflammatory drugs have on the risk of myocardial infarction?
  • Which therapeutic strategies in the management of unstable angina are most likely to reduce the risk of myocardial infarction and death?
  • Does reference pricing, a policy to limit prescription drug expenditures, indeed reduce spending, and what effects does the policy have on other health care utilization?
  • What are the consequences of a formulary restriction of nebulized asthma/COPD medications on quality of life, functional status, and health care utilization in a randomized trial?
  • How cost-effective are pharmaceutical approaches to the treatment of schizophrenia?
  • How well do physicians treat osteoporosis and do patients comply with such therapies?
  • Why do patients comply poorly with lipid-lowering medications and what are the implications of such behavior?
  • How well do physicians conform to published guidelines for treatment of hypertension and what are the financial consequences of these prescribing patterns?

 

Faculty Research Areas

Clinical Topics

  • Asthma and COPD
  • Bone and rheumatic diseases
  • Hematology/oncology
  • Cardiac disease
  • Diabetes
  • Mental health
  • Kidney diseases
  • Vaccines
  • Geriatrics
  • Antibiotics
  • Maternal and child health

Epidemiologic and biostatistical methods

  • Confounding
  • Cost-effectiveness analysis
  • Instrumental variables
  • Meta-analysis
  • Propensity scores
  • Time-series analysis

Quality improvement and translational research

  • Academic detailing
  • E-prescribing and web-based interventions
  • Other interventions
  • Adherence and compliance
  • Benefit design

Drug Policy and Law

  • Drug regulation and safety
  • Generic medications and drug costs
  • Off-label use
  • Patents and intellectual property
  • Medication labels