Student Corner: Pharmacoeconomics – Moving Beyond Clinical

(Rebecca Lalani is currently a second year pharmacy student at the University of Michigan. She attended University of California, Berkeley, where she earned a Bachelor’s degree in Biochemistry and Molecular Cell Biology. Rebecca is President-Elect of the UM chapter of ISPOR and an avid college football fan)

In the current session of Congress, H.R. 3200 in its multiple House and Senate forms is slowly trudging its way to the floor in what could be the most sweep-ing health care bill in recent memory. Deemed the America’s Affordable Health Choices Act of 2009, this bill has roused passion and controversy that suggest a desperately needed overhaul of a multibillion-dollar industry predicated on the relationship between pharmaceutical cost and patient care. With drug and device usage being a significant segment of the overall cost of health care in America, pharmacoeconomics and outcomes research is poised not only to expand, but be the primary dictate by which companies, hospitals and even the federal gov-ernment make health care decisions.

Although the importance of pharmacoeconomics and the need for such research are indisputable, very few pharmacy students choose to enter this field after the completion of their studies. Although not wanting in desire or motivation, phar-macy students are introduced to pharmacoeconomics as a distinct discipline only in their third or fourth year. Given such late and limited exposure, students are far more apt to stick with what they know when deciding potential rotation schedules and ultimate career routes. Compounding the issue (no pun intended) is the misconception that pharmacy only offers fulfilling work in the way of direct patient contact. When asked which field of pharmacy they are considering, first year students will inevitably answer in unison with the ubiquitous “something clinical.” This has traditionally left those of us interested in pursuing internships or experiential training to fend for ourselves. As a second year pharmacy student at the University of Michigan, I have yet to engage in any pharmacoeconomics research myself. However, despite having little background in what pharmaco-economics and outcomes research encompasses, I am able to recognize very quickly the implications that such research would have not only for my patients, but the health care system as a whole.

With the training, understanding and emphasis on patient care that four years of pharmacy school and ample patient interaction has cultivated, pharmacists have a unique set of skills that have proven indispensable in pharmacoeconomics research. The overwhelming majority of students become PharmDs to help other people. The field of pharmacoeconomics achieves this exact goal, except on a much grander scale than working with the individual patient. Coupling scientific knowledge with a compassionate perspective can have far-reaching effects on national policy and subsequently, quality of care. Conveying this ideal early in the pharmacy curricula is certain to spur more interest in the field. Additionally, pharmacy students need to be shown how outcomes research falls well within the purview of their expertise and interest. Pharmacy students like drugs and feel enlivened to apply the detailed medication knowledge they have accumu-lated over the last four years. Health economics includes drug efficacy research, counseling/consulting success rates and even marketing skills! Institution policy decisions are also guided by recommendations based on pharmacoeconom-ics—the most salient way to do “something clinical.”

Besides the lack of emphasis or exposure until the final two years of pharmacy school, outcomes research is rarely acknowledged for the role it currently plays in daily, established practices. The foremost example of applied outcomes re-search that students are aware of is the generic/brand name system in drug dispensing and distribution. If not addressed by individual programs, organiza-tions such as ISPOR need to highlight to students that pharmacoeconomics is the underlying principle guiding what has now become pharmacy canon. Again, pharmacy students will understand more clearly the significance of outcomes research in their practice if exposed earlier in their careers.

With such a minimal amount of health economics information successfully reach-ing junior pharmacy students, ISPOR could (and should) be a pivotal source for students interested in conducting research. Industry related fields of pharmacy are certainly in the minority, and students often find it a fruitless task to search for summer/internship positions when an abundance of community-oriented jobs are so readily available. Additionally, since industry related jobs are in short supply and the competition includes students from a variety of disciplines, secur-ing a research position can be an incredibly daunting task. Resources such as ISPOR’s IPRAP recruiting database and Rutgers industry related internship list should be advertised so that students are aware of the wide variety of fields they could be entering with their degrees. Non-traditional routes in pharmacy (i.e., Industry) are not well publicized and students do not know the terminal point of doing pharmacoeconomics research as a PharmD. If we are to garner more attention from that demographic, ISPOR needs to educate pharmacy students more on the job positions they can acquire after graduating, including fellowship opportunities. Pharmacy fields such as formulary development, bench work in pharmacokinetics, pharmacology, data analysis and even advertising and mar-keting are filled with individuals with PharmD degrees.

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