Specialty Medicines Research

Specialty medicines, many of which are products of biotechnology advances, can provide novel and potentially life-changing treatment options for a growing number of serious conditions, including cancers and inflammatory diseases.  At the same time, the increasingly high costs of specialty medicines represent an enormous economic burden to patients and society.  Allocating scarce resources to specialty medicines involves many difficult ethical and economic decisions for both families and payers.

Medicines and Insurance Coverage (MedIC) Initiative Research

The Medicines and Insurance Coverage (MedIC) Initiative is a unique partnership between academics, health care delivery systems, health care financing institutions, and international organizations.  We seek to improve population health through evidence-informed medicines policies and programs in health systems, with a particular focus on emerging and expanding insurance schemes in low and middle-income countries (LMIC) working toward universal health coverage.

 

MedIC activities focus on

Impacts of HPI on US Health Policies

HPI faculty have established a strong record of national and international leadership in the evaluation of health policy changes in chronically ill populations, particularly insurance coverage for medications on use of essential medication, affordability of medication, and clinical outcomes. These studies, combined with HPI faculty testimony, advice, and major op-eds have had substantial impacts on worldwide healthcare policies in both the public and private sectors.

 

Cancer Policy and Program Evaluation

Research by faculty and fellows in the Department of Population Medicine’s Center for Cancer Policy and Program Evaluation spans the spectrum of cancer care from prevention, screening, diagnosis, and treatment to survivorship and palliative care. The research portfolio includes studies among defined populations to investigate clinical, health services, and policy research questions using a range of innovative research methods.

Innovative Research Methods

For over two decades, HPI faculty have been at the forefront of efforts to upgrade the quality of research methods (especially research designs) to improve the validity of non-randomized evaluations of large-scale natural experiments that cannot be randomized (e.g., Medicare Part D and nationwide cost-containment policies of national and state health reform). Unfortunately, we know little about the risks and benefits of such interventions, particularly for the poor and the sick.

Mental Health Care

HPI has focused much of its research on patients with psychiatric illnesses and their care, due to these patients’ special vulnerability to disruptions caused by administrative or financial changes, and the substantial heterogeneity in responses of patients to specific psychotropic treatments.

Delivery Science

As evidenced in the references below, HPI has several decades of experience in the conduct of experimental and quasi-experimental studies of interventions to improve clinical care among physicians and large delivery systems in numerous states. Below we highlight a recent example related to the goals of the Affordable Care Act.

 

Patient Navigator intervention to reduce hospital readmissions among high-risk safety-net patients

Pharmaceutical Policy

HPI faculty have established a national and global reputation for pharmaceutical policy research, including investigating the impacts of changes in insurance coverage on use of medicines, affordability, and clinical outcomes.  We conducted the first well-controlled studies of the effect of strict state Medicaid drug coverage limits, which demonstrated reductions in use of both nonessential and essential medications, as well as increases in acute and institutional care.  HPI investigators showed that requiring drug prior authorization and step therapy for expensive antipsyc