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    A NNUA L R EPORT 2019 THE COMPARATIVE HEALTH OUTCOMES, POLICY & ECONOMICS INSTITUTE UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 1


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    TABLE OF CONTENTS 2 MISSION STATEMENT 27 CHOICE AND ICER COLL ABOR ATION 3 CHOICE FACULT Y AND STAFF 28 BR AMS UPDATE 4 LET TER FROM THE DIREC TOR 29 FACULT Y HIGHLIGHT: Z ACH MARCUM 5 WELCOME NEW STAFF MEMBERS 30 FACULT Y HIGHLIGHT: A A STHA A BANSAL 6 SABBATIC AL UPDATE: ANIRBAN BA SU 32 UW CHOICE HTF PROJEC T 2019-2021 7 CL A SS OF 2019 33 PHENOM SEMINAR 8 GR ADUATING STUDENT SPOTLIGHT 34 ISPOR 2019 UPDATE 10 NEW STUDENTS/FELLOWS 36 STUDENT HIGHLIGHTS: NATHANIEL AND L AUREN 13 CURRENT STUDENTS/FELLOWS 38 2019 GARRISON PRIZE IN HEALTH POLIC Y & ECONOMICS 19 CURRENT POST-DOCS 39 POPUL ATION HEALTH GR ANT 20 2019 RETREAT REC AP 40 WHERE ARE THEY NOW ? ALUMNI HIGHLIGHTS 22 2ND ANNUAL SYMPOSIUM 4 4 FACULT Y GR ANTS, AWARDS, AC TIVITIES 23 PHARMD/MS FELLOWSHIP PROGR AM UPDATE 47 FACULT Y PUBLIC ATIONS 24 FACULT Y HIGHLIGHT: RYAN HANSEN 49 STUDENT PUBLIC ATIONS 26 HECON CERTIFIC ATE UPDATES 50 DONOR APPRECIATION 26 PNW EVIDENCE BA SED PR AC TICE CENTER GENERATING COMPARATIVE EVIDENCE to INFORM and ENRICH DECISION-MAKING We are a global leader in generating knowledge to improve individual and population health through transformative learning, research, and dissemination about the effectiveness, safety, and value of medical products, services, and policies. OUR MISSION Research: Develop innovative methods and generate actionable evidence about the effectiveness, safety, and value of medical products and services that improve decision making in health care and policy. Training: Provide transformative training in health economics, outcomes research, and policy analysis to meet contemporary health care challenges regionally, nationally, and globally. Service: Be a leading resource on the effectiveness, safety, and value of medical products and services by providing expertise and facilitating collaborations at the regional, national, and global level 2 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    “The hallmark of our program is its proven impact on local and national policy.” SEAN D. SULLIVAN, PROFESSOR & DEAN UW SCHOOL OF PHARMACY 125 & 25 This year, both the School of Pharmacy and the CHOICE Institute are celebrating a major milestone. 2019-2020 marks 125 years as a School of Pharmacy, and 25 years since the Pharmaceutical Outcomes Research and Policy Program (PORPP) was officially designated at the UW. Now as the CHOICE Institute, we continue to grow and transform, expanding our impact on population health. CHOICE FACULTY SENIOR SCIENTISTS David Au, MS, MD Lurdes Inoue, MS, MS, PhD Lisa Bloudek, PharmD, MS Adjunct Professor Adjunct Professor Research Scientist Engineer Joseph Babigumira, MBChB, MS, PhD Jerry Jarvik, MD, MPH Greg Guzauskas, PhD, MPH Adjunct Associate Professor Adjunct Professor Research Scientist Engineer Aasthaa Bansal, PhD Larry Kessler, ScD Associate Professor Adjunct Professor STAFF Douglas Barthold, PhD Gary Lyman, MD, MPH Research Assistant Professor Adjunct Professor Marina Gano, M.Ed. Anirban Basu, PhD Zachary Marcum, PharmD, MS, PhD Graduate Program & Stergachis Family Endowed Director Assistant Professor Operations Manager & Professor Paul Kraegel, MSW Scott Ramsey, MD, PhD Brian Bresnahan, PhD Adjunct Professor, Director, Program Operations Specialist Adjunct Research Associate Professor HICOR (Hutchinson Institute for Anthony Morgan Cancer Outcomes Research Research Project Manager Josh Carlson, MPH, PhD and Evaluation), Fred Hutchinson Associate Professor, Associate Cancer Research Center Director, Graduate Programs Andy Stergachis, PhD Beth Devine, PharmD, MBA, PhD Professor, Associate Dean for Professor, Director, Research, Graduate Education Graduate Programs & New Initiatives David Flum, MD, MPH Sean Sullivan, PhD Adjunct Professor Professor and Dean, Louis Garrison, Jr., PhD UW School of Pharmacy Professor Emeritus David Veenstra, PharmD, PhD Shelly Gray, PharmD, MS Professor, Associate Director Shirley & Herb Bridge Davene Wright, PhD Endowed Professor Assistant Professor, Pediatrics; Ryan Hansen, PharmD, PhD Adjunct Assistant Professor Assistant Professor Thomas Hazlet, PharmD, DrPH Associate Professor UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 3


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    FROM THE DIRECTOR I am pleased to present the 2nd Annual Report for The Compar- The grant productivity of the CHOICE Institute continues ative Health Outcomes, Policy, and Economics (CHOICE) Insti- to be strong and diversified. CHOICE investigators received tute. We’ve had a wonderful and productive year, with several over $2M in grant and contract funding over the past important changes to our most valuable asset – our people! year from a wide variety of sources including NIH, AHRQ, foundations, and industry. Brand new awards include Please join us in welcoming Marina Gano to The CHOICE Zach Marcum’s career development award from the NIH’s Institute as our Graduate Program & Operations Manager. Many National Institute of Aging (NIA) for pharmacoepidemiology of you had the pleasure of meeting Marina at the recent ISPOR studies in Alzheimer’s Disease, and Beth Devine’s award meeting in New Orleans. She brings exceptional leadership from AHRQ to study the use of electronic decision alerts for and organizational skills to her position and is a strong student pharmacogenomic tests. advocate. We are so pleased she has joined the CHOICE team! We continue to expand our post-PharmD fellowship training, I’m also happy to introduce Anthony Morgan (who goes with the addition of a second Genentech fellow, and a new by Morgan), CHOICE’s first Research Project Manager. Seattle Genetics fellowship. Training clinicians in HEOR – Morgan will lead administrative support and oversight for particularly PharmD’s – has always been a key focus of our multi-funded and multi-site research studies with a focus program. The CHOICE faculty have been intimately involved on population health sciences, medical products and health with the newly revamped UW PharmD curriculum, which will technology evaluation, and health economics. Morgan brings in part help identify and train PharmD students interested a wealth of experience, knowledge and skill to the position of in HEOR earlier in their training. A special shout-out goes Research Project Manager at the CHOICE Institute. out to our UW PharmD team that won the Academy of CHOICE faculty and students continue to be recognized Managed Care Pharmacy (AMCP) annual national Pharmacy for their achievements – I’ll highlight a few here. First, & Therapeutics (P&T) Competition for Student Pharmacists! congratulations to 3rd-year PhD student Lauren Strand Many of the students who compete in this competition go who was named a UW Magnuson Scholar. Magnuson Scholars on to apply for fellowships and PhD programs, so it is a great are selected for their excellent academic performance and connection we enjoy being part of. outstanding potential for research in the health sciences. It was wonderful to see our alumni and friends at ISPOR in Lauren will investigate the relationship between recreational New Orleans, and for those who could not make it we hope cannabis use in Washington state and opioid overdose. to connect with you in the coming year. We remain ever Elizabeth “Lizzy” Brouwer (5TH th-year PhD student) has grateful for your continued support that is instrumental to been awarded the prestigious Pharmaceutical Research and our success in the future. Lastly, I’d like to welcome all of Manufacturers of America Foundation (PhRMA) 2019 Pre- our new students and post-docs. You are the future of our Doctoral Fellowship in Health Outcomes. This award will provide Institute and our field. Lizzy with dissertation support to study the uptake of value- Sincerely, based formularies and their application to specialty drugs. The Oregon State University College of Pharmacy honored David Veenstra, PharmD, PhD Sean D. Sullivan with the 2019 Icons of Pharmacy award. Acting Director, The CHOICE Institute Sean was recognized for his leadership as Dean at the UW School of Pharmacy, where his engagement has helped transform the profession. Sean had this to say about life as a Dean, “This is a job none of us are trained for. Most days, it’s challenging. Some days, it’s extremely difficult. And on a few occasions, it is glorious.” The editors of Health Economics named Anirban Basu the 2019 Health Economics Distinguished Author. We did notice he had some great co-authors from CHOICE too! As some of you know, Anirban is on sabbatical in London during summer and fall quarters. 4 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    WELCOME: NEW CHOICE STAFF MEMBERS MORGAN: CHOICE RESEARCH PROJECT MANAGER Anthony Morgan (preferred name Morgan) is the newly hired Research Project Manager for The CHOICE Institute! Prior to joining us here at UWSOP, he coordinated single and multi- site clinical and exploratory research at Johns Hopkins in Baltimore and more recently at Seattle Children’s. Morgan will be providing high level support to CHOICE Director Anirban Basu and other CHOICE investigators, including Aasthaa Bansal. In general, he will lead administrative support and oversight for multi-funded and multi-site research studies with a focus on population health sciences, medical products and health technology evaluation, and health economics. Morgan has been managing public health programs and research projects MARINA: GRADUATE PROGRAM AND since 2002. He has a strong history of managing multiple OPERATIONS MANAGER public health programs and research initiatives focused on Marina Gano is our new Graduate Program and Operations a variety of racial, sexual and gender minority adolescents Manager and joined in February. Marina grew up in and emerging adults. Morgan brings a wealth of experience, Fairbanks, Alaska with brief periods in Germany and knowledge and skill to the position of Research Project Maryland. She earned a Bachelor of Arts in Foreign Manager at the CHOICE Institute. We are so pleased he has Languages and Literature (Spanish and German) from the joined the team here. University of Alaska Fairbanks (UAF). Her career in higher education began in the Office of Admissions and Registrar at UAF, and then moved to the UW in 2014 as an advisor in Graduate Enrollment Management Services (GEMS). In this role, Marina provided advising, training, and support to the staff, faculty, students, and applicants of the three UW campuses. Marina recently earned a Master of Education degree in Educational Leadership and Policy Studies (Higher Education) from University of Washington. Through her role in GEMS and her graduate program, she’s gained valuable knowledge and perspectives regarding graduate education and the UW, which has served to be an asset thus far in this role. She says she learns something new every day in CHOICE and has felt very fortunate to have landed here with such a collaborative, creative, and fun group of faculty and students. She appreciates how welcoming and supportive everyone has been in CHOICE and the School of Pharmacy in general. In her free time, Marina enjoys cooking and trying new recipes, listening to podcasts, gardening, traveling, creating art and spending time with her cats Cosmo and Luna. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 5


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    CHOICE DIRECTOR’S SABBATICAL IN LONDON: JULY – DECEMBER 2019 From Seattle to London, or, where in the world is Dr. Anirban Basu? As previously noted, CHOICE director, Anirban Basu, is currently on a six-month sabbatical in another rainy city across the pond, at the London School of Hygiene and Tropical Medicine (LSHTM). His objective is to develop novel methods in machine learning and causal inference, , which aligns with his experience and expertise. This was identified as a strategic need for the CHOICE Institute during our strategic planning process. His time in London will not only be a great learning experience, but will enrich our connections with the global research community, strengthen our long-term funding prospects, and enhance our own DR. BASU WITH CHOICE AFFILIATE PROFESSOR LOTTE STEUTEN AT research programs. THE LONDON OFFICE OF HEALTH ECONOMICS. Anirban gave two noteworthy talks over the summer as part of his sabbatical activities. He presented a lecture at LSHTM titled, “Economics of choices in the era of personalized medicine”. In this lecture, Anirban discussed how assessments of value and insurance coverage can reflect evidence of heterogeneous treatment effects and inform moves towards precision medicine. He also spoke at the London Office of Health Economics (OHE) – featured in the photo here with CHOICE Affiliate Professor Lotte Steuten, where he gave a seminar entitled, “Health Years in Total (HYT): A New Health Objective Function for Cost- effectiveness Analysis”. The new HYT framework is the is the product of CHOICE faculty research and grew out of our collaboration with with the Institute for Clinical and Economic Review (ICER) project. This new metric of TOURING THE ROMAN WALLS IN YORK WITH KARL CLAXTON, PHD, effectiveness for cost-effectiveness, Health Years in Total PROFESSOR AT THE DEPARTMENT OF ECONOMICS AND RELATED STUDIES AT THE UNIVERSITY OF YORK. (HYT), overcomes both the distributional issues raised by Quality-Adjusted Life-Years (QALYs) and the efficiency challenges of Equal Value of Life (EVL). The HYT framework fundamentally separates life-expectancy changes and quality of life changes in an additive scale. Dr. Josh Carlson will be presenting on this new framework at the Corporate Advisory Board Meeting this fall. We (especially Dave) look forward to welcoming back Anirban in January! 6 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2018 2019 ANNUAL REPORT


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    CLASS OF 2019 MASTER OF SCIENCE Shalak Gunjal Jamie Ta BPharm 2012, University of Pune, BS 2013, PharmD 2018, University of India; MS 2014, University of California San Diego Houston THESIS: “Healthcare Resource THESIS:“Healthcare Utilization and Utilization and Costs Associated with Costs associated with Sickle-cell Non-Adherence to Pharmacotherapy disease in the United States: A for Major Depressive Disorder” Retrospective Claims Analysis” ADVISOR: Beth Devine, PharmD, ADVISOR: Anirban Basu, PhD MBA, PhD Thomas Hopkins BS 2014, Loyola University of Chicago; PharmD 2018, University of Illinois Chicago DOCTOR OF PHILOSOPHY THESIS:“Surgical Costs Associated with the Treatment of Uterine Simrun Grewal Fibroids” BA 2008, Washington University in ADVISOR: Ryan Hansen, PharmD, PhD St, Louis; MHS 2013, Johns Hopkins University DISSERTATION: “Biosimilar uptake in the United States: Examining state-level longitudinal trends in biosimilar filgrastim Ashley Kim use and their association with biosimilar BS 2012, University of California Los substitution policies” Angeles; PharmD 2018, University of San Francisco COMMITTEE: Josh Carlson, PhD (Chair), Anirban Basu, PhD, Andy Stergachis, Ryan Hansen, THESIS:“Characterizing the Healthcare PharmD, PhD, Jennifer Slyker, PhD (GSR). Resource Utilization and Costs By Disease Severity Among Patients with Geographic Atrophy Secondary to Age- Kangho Suh Related Macular Degeneration” BA 2007, New York University; ADVISOR: Aasthaa Bansal, PhD PharmD 2011, Rutgers University; 2013 MS, University of Texas Austin DISSERTATION: “The comparative Eddie Neuberger effectiveness, safety, value, and BS 2013, PharmD 2017, University adherence of newer P2Y12 inhibitors of Maryland; MBA 2018, University versus clopidogrel in the context of Baltimore of heterogeneity” THESIS: “Evaluating Methods to COMMITTEE: Anirban Basu, PhD (Chair), Estimate United States Multiple Josh Carlson, PhD, Kelley Branch, MD, Sclerosis Prevalence from Bianca Frogner, PhD (GSR). Administrative Health Claims Data” ADVISOR: David Veenstra, PharmD, PhD UNIVERSITY OF UNIVERSITY OFWASHINGTON WASHINGTONSCHOOL OFOF SCHOOL PHARMACY 5 7 PHARMACY


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    GRADUATING STUDENT SPOTLIGHT: SIMI AND KANGHO SIMRUN GREWAL, MSH, PHD For her dissertation research, Simrun (Simi) examined the state-level use of biosimilars, identifying three unique average biosimilar filgrastim uptake trends occurring sub-nationally in the United States. She found that while the overall impact of state-level biosimilar substitution policies is ambiguous, specific components of the policies may have interesting associations with biosimilar use. Dr. Josh Carlson serves as her dissertation chair, alongside fellow Pharmacy faculty, Drs Anirban Basu, Andy Stergachis, Ryan Hansen, and Jennifer Slyker (Graduate School Representative, Global Health). Simi earned a Bachelor of Arts in 2008 from Washington University in St. Louis and her Master of Health Science from Johns Hopkins University in 2013. Prior to her graduate education, Simi spent several years using modeling methods to inform the develop or revision of formularies in low- and middle-income countries. While at Johns Hopkins, she completed a thesis using discrete choice experiment methodology and worked on a suite of economic models for vaccines. Simi was fully funded through the duration of her PhD program. She received the Graduate School’s Top Scholar Award upon entering the program, followed by 1.5 years on the NIH-funded PriMER Project supervised by Dr. Josh Carlson, and lastly spent 2.5 years working with the Bill and Melinda Gates Foundation through the UW START program. Reflecting on her time as a CHOICE PhD student, Simi will miss the program environment that entices all students to learn and engage in their areas of passion in healthcare economics. Luckily, she will be in the Seattle area and looks forward to staying involved with CHOICE. Simi has recently started a position as a Manager in Global Value, Access, and Pricing at Seattle Genetics. Congratulations, Simi! As for what comes next, apart from her exciting new career, Simi hopes to adopt a puppy in 2020. We are holding her to this aspiration, so stay tuned for photos in next year’s annual report. 8 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    KANGHO SUH, PHARMD, PHD Kangho completed his dissertation titled, “The comparative effectiveness, safety, value, and adherence of newer P2Y12 inhibitors vs. clopidogrel in the context of heterogeneity.” He used an instrumental variable approach with person-centered treatment effects to assess physician prescribing behavior with P2Y12 inhibitors and the subsequent effect on major adverse cardiovascular events and major bleeding outcomes. On average, the newer P2Y12 inhibitors performed better than clopidogrel, but significant room for improvement exists as personalizing select patients to clopidogrel would lead to even better outcomes. In the cost-effectiveness analysis, universal treatment with the newer P2Y12 inhibitors was cost- effective compared to universal treatment with clopidogrel and historical prescribing patterns of the three antiplatelet agents. The third aim assessed adherence using conditional and unconditional quantile regressions and showed that while adherence was generally high for all the P2Y12 inhibitors, prasugrel and ticagrelor had significantly lower adherence at certain quantiles compared to branded clopidogrel, while generic clopidogrel did not. surveillance adherence. He was also part of the inaugural class of Washington Research Foundation health economics and Kangho graduated magna cum laude with a PharmD from the outcomes research fellows and built a cost-effectiveness model Ernest Mario School of Pharmacy, Rutgers University in 2011. that assessed the potential value of a functional cure Afterwards, he completed a health economics and outcomes in hepatitis B. research fellowship with the University of Texas at Austin (where he obtained a Master’s in Pharmacy Administration), Kangho truly enjoyed and appreciated his time iat CHOICE, Scott & White Health Plan, and Novartis Pharmaceutics. To the University of Washington, and Seattle. He will miss the advance his methodological training, he entered the CHOICE mentorship and collegiality of the faculty, the friendships PhD program in the Fall of 2014. with students and fellows in the program, and even working in the grad room. The most memorable experiences were During his time at CHOICE, Kangho was funded by research the overnight annual CHOICE retreat, ISPOR nights out with assistantships with the Health Tech Fund on defining and faculty and students, and the dinners hosted by fellow CHOICE valuing cures and highly-effective therapies, as well as with alumnus Dr. Mark Bounthavong. funding from Dr. Anirban Basu and Kaiser Permanente Southern California to compare two types of bariatric Starting in September, Kangho will start his academic career as surgeries on several health outcomes. He also worked with an Assistant Professor at the University of Pittsburgh School of Dr. Ryan Hansen on multiple sclerosis treatment and post- Pharmacy. He plans to continue focusing on comparative and traumatic stress disorder psychotherapy projects and with cost-effectiveness research and help teach in these areas. Dr. Aasthaa Bansal on post-treatment colorectal cancer UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 9


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    WELCOME: NEW PHARMD/MS FELLOWS Ashley Cha, Bayer Jae Hyun Lee, Allergan BA, PharmD, University BS, University of California of Illinois at Chicago San Diego; PharmD, Ashley’s research interests are in University of Illinois health economics and outcomes at Chicago research, specifically in the areas Jae’s research interests largely of patient reported outcomes, real stem from his previous work at UIC world evidence, and cost-efficacy and Dymaxium. He is excited to anlyses. She is excited to join the develop his research skills in cost- CHOICE Institute and looking effectiveness analysis, real world forward to working with the UW evidence, systematic reviews and faculty and the Bayer team. economic modeling. He is looking forward to expanding his research interests while working with the Sam Hong, Genentech CHOICE faculty and Allergan team. BS, University of California, San Diego; PharmD, University of Illinois David Fox, Genentech at Chicago BS, San Francisco State Sam’s interest in health economics University; PharmD, and outcomes research (HEOR) University of Washington stemmed from the growing David’s research interests include integration of real-world data in healthcare resource allocation, decision making by all stakeholders. health policy, and the economics His specific research interests of treating rare diseases. He first include cost-effectiveness analyses, became interested in managed retrospective claims/electronic care through involvement in medical records analyses, and patient the AMCP P&T competition, a summer reported outcomes. He is excited to internship at Premera Blue Cross, and work with the UW CHOICE faculty research with Dymaxium. David also spent and Genentech team in developing a a month in Boston with the Institute for strong foundation in HEOR principles. Clinical and Economic Review (ICER) which persuaded him to pursue a career in health economics research. David enjoys discussing the minutiae of politics, healthcare, and learning how things work. He welcomes any pharmacy students interested in health economics to contact him with questions. 10 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Brennan Beal, Allergan Phoebe Wright, BS, North Carolina State Seattle Genetics University; PharmD, BS, University of Tennessee, University of North Carolina Knoxville; PharmD, at Chapel Hill University of Washington; Brennan recently graduated from Phoebe is a graduate of the the UNC Eshelman School of University of Washington School Pharmacy where he conducted of Pharmacy. She developed research and acted as an a strong interest in value independent data analyst for local assessment of therapies during pharmaceutical firms. His current her rotations in PBM, health plan, and consulting research interests are in global settings. Her specific research interests include healthcare economics, emerging performance-based risk-sharing agreements and markets, and RWE. Brennan was drawn patient-reported outcomes. Prior to pharmacy to the program because it merges school, she was a professional runner for Nike some of the best pharmaceutical firms where she represented Team USA in the World in the world with the brightest minds Championships. She is excited to join the CHOICE in HEOR academia and is ecstatic for institute and receive formal training in comparative his role to come. effectiveness research, cost-utility analysis, epidemiology, health policy, and biostatistics. She plans to use this education to improve patient care in the oncology space at Seattle Genetics. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 11


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    WELCOME: NEW PHD STUDENTS Yilin Chen Sara Khor BS, Wuhan University; BASc, MASc, MPH, Global Health, University of Toronto University of Washington Sara received her Masters in Yilin joins us from the Analysis Biomedical Engineering from the Group in Boston, where she University of Toronto and has currently works as an analyst in the years of experience as a health HEOR team. Her interests include services researcher in academic economic evaluation and decision and government settings. She most analysis of medical technologies recently joins us from the Surgical and programs, both domestically and Outcomes Research Center at the University internationally. She is looking forward to of Washington where she has been a research collaborating with faculty and peers at the scientist for the last 5 years conducting CHOICE Institute. Her ultimate goal is to comparative effectiveness and health work as a researcher in the field of HEOR outcomes research. Her primary research and policy within public or private sectors. interests include healthcare disparities and health economics. Sara is excited for the opportunity to continue to learn advanced Shangqing (Joyce) Jiang methods from the CHOICE faculty. Her BS, BA, Peking University; ultimate goal is to work as a researcher in a MPH, Columbia University health system, policy-making institution, or in Joyce studied Epidemiology and academia to improve healthcare equity. Comparative Effectiveness & Outcomes Research at Columbia University as a Master of Public Jacinda Tran Health (MPH) student. While BS, UCLA; PharmD, pursuing her MPH degree, she University of Maryland, was a research assistant in Baltimore; MBA, projects in health economics, surgical outcomes and University of Baltimore mental health. In addition, she was actively involved in Jacindajoins us from San Diego, healthcare consulting in health economics & outcomes California, where she is currently research as an analytic intern. Joyce is enthusiastic about a Research Associate at IMPAQ collaborating with faculty members and peers at the International. She is excited to join University of Washington to promote her knowledge in CHOICE and work with the faculty, how pharmaceutical economics contributes to patients’ students, and external collaborators. health outcomes and policy-making. Joyce is mostly Jacinda also looks forward to strengthening interested in drug post-marketing surveillance of safety her foundation in research methods and and effectiveness in patients with chronic conditions and developing her modeling and quantitative cancer. In addition, she hopes to understand economic skills in the PhD program, with the goal of burden for individuals and the society by conducting pursuing a career in academia. Jacinda’s economic evaluation. Ultimately in the long run, she research interests include health economic hopes to work in regulatory agencies to contribute to and policy evaluation, value-based care, pharmaceutical policy-making. Joyce also looks forward and comparative effectiveness research. to living in Seattle and exploring her new city! 12 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    CURRENT STUDENTS AND FELLOWS Elizabeth “Lizzy” Brouwer Shuxian Chen, MPH, PhD Student MA, PhD Student Lizzy is entering her fifth year Shuxian is excited to begin her at the CHOICE Institute. This fourth year as a CHOICE PhD year has been quite eventful for student. This past year was not Lizzy. In June, she passed her shy of accomplishments, as general qualifying exam with a Shuxian succesfully completed dissertation entitled: “Exploring her dissertation proposal defense. the uptake of value-based Shuxian’s dissertation work is formulary strategies and their focused on evaluating several application to specialty drugs”. recent health care policies which Her dissertation topic led to will accelerate generic drug a July 2019 publication in the entry to the market. In fall at the PharmacoEconomics journal. Lizzy presented a poster at ISPOR Academy of Managed Care Pharmacy (AMCP) Nexus Meeting, in New Orleans on Identifying and Assessing the Feasibility of Shuxian and Dr. Beth Devine debuted their newly developed Proposed Alternative Approaches to QALY Estimation within framework and tool that guides users in evaluating real world Cost-Effectiveness Models Using a Systematic Literature Review. evidence (RWE) to inform health technology adoption decisions She received the UW Population Health Initiative Conference – the CHOICE “Real-world Evidence Assessments and Needs Travel funding to travel to ASHEcon 2019, where she gave Guidance (REAdi) Tool.” She has also been working with Dr. Doug a panel presentation on the impact of federal, state, and Barthold examining the effects of undetected cognitive decline commercial prescrption drug access policies. She worked with on prescription medication management and adherence. This Josh Carlson’s PHRMA grant project to explore alternatives to summer Shuxian has been interning at Flatiron Health in New the QALY and their impact on outcomes in cost-effectiveness York City, where she has been enriching her knowledge of cancer models. Additionally, she has been a TA for the CHOICE online outcomes research as well as next generation sequencing. She Health Economics certificate program’s Saudia Arabia/AbbVie looks forward to diving deep into her dissertation work in the cohort. Lizzy continually gives back to CHOICE, serving this year ahead and plans to graduate in spring. year on the annual retreat committee and as lead editor of the CHOICE student blog. She was awarded a PhRMA Foundation Samantha Clark, MS, pre-doctoral fellowship and was a recipient of the 2019 Lous PhD Student Sr. and Marilyn Garrison Endowed Prize in Health Policy and Samantha is beginning the Economics. She looks forward to the year ahead, where she will third year of her PhD program. work with Anirban Basu on his Kaiser VSG R01 grant, defend her This year, Samantha received a dissertation, and graduate. Developing Data-Driven Cancer Researchers (3DCR) Training (T32) Grant Award through the Fred Hutch Cancer Research Center. This training grant prepares scientists on how to address the cancer research needs of our data-rich age, optimizing the use of new data resources. In addition to serving as a 3DCR T32 trainee, Samantha works with Dr. Aasthaa Bansal analyzing electronic health records data from Kaiser Permanente on Bansal’s Personalized Risk AdaptIve Surveillance in CancEr (PRAISE) project. She will continue both of these roles in the year ahead. She enjoyed serving as a Teaching Assistant for PHARM 592: Design and Analysis of Medical Studies this past UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 13


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    CURRENT STUDENTS AND FELLOWS continued fall. She presented a poster at SMDM on adult pneumococcal Beth Devine on the Cancer Health Assessments Reaching Many disease burden in the United States in the fall, and in spring (CHARM) study. Karen is currently mentoring a Master’s student presented another poster at ISPOR on implications of using a from her alma mater, The London School of Economics, in the data integration pipeline to streamline the clinical trial process Department of Health Policy. For the year ahead, Karen looks for glioblastoma treatment combinations. This summer, forward to finalizing her dissertation topic and continually Samantha is a visting fellow at the Harvard T.H. Chan School of helping PhD students connect with job agents in US, UK and Public Health Center for Health Decision Science and working on Singapore markets. the inaugural summer student bootcamp for claims research. She enjoys supporting her fellow students and is a CHOICE Nathaniel Hendrix, student body representative, and our ISPOR chapter secretary. PharmD, PhD Student Nathaniel is entering his fifth Ashley Kim, PharmD, and final year of the PhD program. He started this past MS, 2nd Year Fellow year off with a bang by defending Ashley is entering her 2nd year his dissertation proposal in of the UW/Allergan fellowship. October. He continues to work During the past year, Ashley on his dissertation, which worked on various research concerns using the tools of areas in the areas of metastatic health economics to resolve non-small cell lung cancer translational issues around and age-related macular bringing machine learning- degeneration. She has been based diagnostics into clinical practice. He delved into working the GHEOR eye care pharmacoepidemiology research for the first time this year and team at Allergan to develop found that he really enjoyed it! Nathaniel received a Developing her master’s thesis, where she analyzed IQVIA claims data to Data-Driven Cancer Researchers (3DCR) Training (T32) grant describe the overall burden of illness of geographic atrophy this year and is a continuing PHRMA foundation fellow. He also by disease severity. She is grateful for her year-long training at served as a TA for PHARM 541, “Pharmacy, healthcare, and UW, and is excited to transition to Allergan, where she will be society” and has supported the School of Pharmacy as a TA on supporting the eye care pipeline. its ongoing curriculum changes. This summer, Nathaniel will be giving a podium presentation at the International Conference He (Karen) Guo, MS, MPH, PhD Student on Pharmacoepidemiology and Drug Safety: “Drug survival Karen is entering her third year of targeted therapies for plaque psoriasis: evidence from a at the CHOICE Institute. In her large U.S. claims database. He has also been working on his second year, Karen worked with data collection for the discrete choice experiment that makes Dr. Dave Veenstra utilizing the up one of his dissertation aims. He has provided leadership value of information analysis to in developing and delivering a summer “bootcamp” on claims increase family communication research for industry fellows and interested PhD students. His about colorectal cancer with or goal for next year is to finish his dissertation and defend in time without polyposis (CRC/P) risk for a June graduation. and screening. Karen presented a poster at the Society for Medical Decision Making (SMDM) in Montreal titled, Modeling the Cost-Effectiveness of Six Diagnostic Strategies for Suspected Pediatric Appendicitis. “Karen is also a Washington Research Foundation fellow, where she is supporting Institute for Systems Biology design an economic model for sepsis. Beginning this summer, Karen is transitioning to work as a research assistant with Professor 14 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Thomas Hopkins, PharmD, Erik Landaas, MPH, MS, 2nd Year Fellow PhD Student Tom is entering his 2nd year of the Erik is entering the fourth year UW/Bayer fellowship. He joined of his PhD program. His short us from the University of Chicago proposal was approved in in Illionis where he earned his spring and he looks forward to PharmD, not far from where he completing his general exam in earned his Bachelor’s degree in autumn quarter. Erik works as Biology at Loyola University of the Director of Health Technology Chicago in 2014. This year, Tom Assessment at UW Medicine, worked with Dr. Ryan Hansen as which aligns with his dissertation his faculty mentor. As Tom worked topic. For Erik’s dissertation his way through his graduate he will be evaluating the studies, he performed a thorough systematic literature review development and effectiveness and developed a full cost-effectiveness model comparing of a hospital based health technology assessment (HB-HTA) two second-line agents for the treatment of hepatocellular program at UW Medicine. He plans to defend and graduate carcinoma. His thesis topic was on the surgical costs associated in spring 2020. Erik received a Department of Global Health with the treatment of uterine fibroids and conducted a student travel grant, which he will utilize for travel to central retrospective cohort analysis of those costs. We wish Tom the Thailand to continue his clinical trial work on the PupilScreen best in his second year of his fellowship with Bayer. phone app. PupilScreen uses smartphone technology and machine learning to detect traumatic brain injury. Erik will Boshen Jiao, MPH, conduct study oversight with hospitals in Thailand to ensure PhD Student good study fidelity. He presented two posters at ISPOR in New Orleans this year, on a health technology assessment Boshen is beginning year two of a less invasive bladder cancer test and on incorporating of his PhD program. Through health technology assessment into laboratory medicine at UW his research experiences in the medicine. Erik is the outgoing ISPOR student chapter president past year, Boshen increased and we all thank him for his outstanding work in the role. his interests in methodological issues in cost-effectiveness analysis and values of emerging Woojung Lee, PharmD, genetic testing and therapies. PhD Student Boshen completed his work with Woojung is starting her second Dr. Anirban Basu developing a year at the CHOICE Institute. This catalogue of future medical costs summer she has been interning in the US. The abstract has been accepted for presentation with the Adaptive biotechnologies at the 2019 Society for Medical Decision Making Conference. Market Access Team, where she Boshen also started his research assistantship with Dr. Beth is studying clinical utility and Devine conducting a landscape analysis for sickle cell disease validity of assessing minimal (SCD), and he was part of the Health Tech Fund project with Dr. residual disease in chronic Dave Veenstra evaluating real world evidence used in clinical lymphocytic leukemia treatment guidelines and ICER reports. In addition, he worked with Dr. and building an economic model Ruth Etzioni at the Fred Hutch on a cost-effectiveness analysis that examines the economic value of emerging biomarkers in prostate cancer screening. During of treatment discontinuation. This past year, and continuing the past summer, Boshen learned important research skills through the next, Woojung has provided stellar support to the and interacted with researchers from various fields. Boshen is School of Pharmacy Health Tech Fund (HTF) projects with Dave excited to continue his work with Dr. Beth Devine on the SCD Veenstra. Their projects aim to see how real-world evidence project. He also plans to complete all the coursework and write can be utilized to inform health economic decision making. the short proposal for his dissertation. These experiences have fostered a deeper understanding of RWE, to see how evidences are used to inform payers’ decision UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 15


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    CURRENT STUDENTS AND FELLOWS continued making, and to learn how to communicate with payers. She Tricia Rodriguez, MPH, is enjoying the opportunity to explore her interests with our PhD Student faculty. Her work with the HTF project sparked an interest Tricia is entering her third in robust methods of converting real world data (RWD) into year as a PhD student, and RWE that can be used for outcomes research and regulatory after recently completing her purposes. She has also found interest in examining drug preliminary exams, is gearing up utilization problems with older adults, which led her to work for submiting her short proposal with Dr. Zachary Marcum on dementia prevention during the to the CHOICE faculty. Tricia’s past year. She presented a poster at ISPOR in New Orleans dissertation work will focus on on some of this work, titled, Do patient Concerns about developing and assessing the Antihypertensive Use for Dementia Prevention vary by Current real-world value of a machine Use of Antihypertensive? For the academic year ahead, learning-based risk prediction Woojung hopes to identify her dissertation topic and work hard model in cystic fibrosis. She is on her preliminary exams. also finishing up her two-year AHRQ T32 training fellowship with Health Services and looks forward to working as an Eddie Neuberger, RA with Jennifer Bacci and Peggy Odegard’s on the Gaps in PharmD, MS, MBA, Diabetes Care – Statins (GuIDE-S) Study, a project with the 2nd Year Fellow School of Pharmacy Institute for Innovative Pharmacy Practice. Eddie received his PharmD at the She is also working on a WRF fellowship this summer, where University of Maryland School we are performing an early stage economic evaluation of a of Pharmacy and worked for a novel treatment for abscess, developed in UW’s applied physics year in community pharmacy lab. She gave a podium presentation this year at the NRSA following graduation; during confernce in DC on a machine learning approach to prediciting which time he obtained his MBA mortality for individuals with cystic fibrosis. Her goals for the from the University of Baltimore. academic year are to continue finalizing her dissertation short He completed his MS at the proposal, and take her general exam. University of Washington, taking courses including economic Enrique Saldarriaga, MS, evaluation, epidemiological methods, and biostatistics. In PhD Student addition to coursework, Eddie conducted research regarding Enrique is entering the third year cost-effectiveness of a new medication in Lennox Gastaut of his PhD program. Enrique is Syndrome, prevalence of Multiple Sclerosis, and factors interested in examining obesity associated with initiating therapy in Multiple Sclerosis patients. trends and metrics on a global Eddie is now entering his second year of the UW CHOICE scale. He presented two posters Institute/Genentech Fellowship, where he looks forward to at ISPOR in New Orleans, one applying his UW training to support Multiple Sclerosis and was on the income-elasticity of influenza products on the Genentech Evidence for Access team the body mass index in Peru, in South San Francisco. and the second was about the cost-effectiveness of a secondary prevention strategy to delay progression of renal replacement theory. This year he received the Stergachis Endowed Fellowship for International Exchange and the South African Centre for Epidemiological Modelling and Analysis (SACEMA) scholarship to attend one of the International Clinics on Infectious Disease Dynamics and Data. Enrique attended the Clinic on Meaningful Modelling of Epidemiological Data, hosted by the African Institute for 16 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Mathematical Sciences in Muizenberg, South Africa. Enrique Lauren Strand, MS, PhD gained valuable experience at this clinic, which emphasizes Student the use of data in understanding infectious disease dynamics Lauren is entering her fourth through modeling projects. Enrique worked with Dr. Anirban year in the PhD program. Basu this past year on the project “health Mass Index: Lauren’s dissertation topic obesity metrics to reflect health rather than growth”. Over examines cannabis as a the summer, Enrique is working with Dr. Jessica Jones-Smith substitution for prescription from the Department of Health Services, on the Collaborative drugs, and she will research on Obesity Research and Action (CORA) project, as well as longitudinal trends in the new completing an internship at the Institute for Disease Modeling era of legal cannabis. This year, (IDM) Health Economics division. Enrique served on the Lauren served as the graduate CHOICE annual retreat this year and is the incoming ISPOR student representative to the chapter president. This year, he plans to define his dissertation CHOICE admissions committee, topic and committee and get his proposal approved. editor for the CHOICE student blog, ISPOR student chapter treasurer, and is the Vice President of the Washington Yacht Naomi Schwartz, MPH, Club Vice Commodore. She has been working as a TA for PhD Student the CHOICE Institute’s Health Economics Online Certificate Naomi joined us last year program. Over the summer Lauren has been updating course after completing her MPH in content for the HECON certificate and serving as a Washington Epidemiology from the University Research Foundation fellow. Lauren received the prestigious of Washington. As she enters her Magnuson Scholar award for 2019-2020 as well as a Rubenstein second year of the PhD program, Fellowship. She attended the National Bureau of Economics her goals are to continue Research (NBER) Health Economics Bootcamp in 2018. For completing her core courses, to the upcoming year, Lauren’s goals are to pass her general begin her dissertation planning exam, attend a substance use conference, and get sailing work and continue serving as certifications. one of the two inaugural CHOICE student representatives, a new Jamie Ta, PharmD, MS, initiative created this year to enhance the student experience, 2nd Year Fellow as well as ensuring student voices are brought to the table at Jamie is entering her 2nd year of our quarterly CHOICE faculty meetings. Naomi presented a the UW/Allergan fellowship. Prior poster at the American Society of Clinical Oncology this spring to the fellowship, she received titled, “Is neratinib following trastuzumab in early-stage HER2- her BS and PharmD from the positive breast cancer cost-effective?”. Naomi was an AHRQ University of California, San T32 fellow this past year and transitioned from this fellowship Diego. During the first year of to an exciting internship opportunity over the summer at the fellowship, Jamie worked Seattle Genetics with CHOICE alum, Zsolt Hepp, Associate on various research projects in Director of Health Economics Outcomes Research (HEOR). She Major Depressive Disorder. For will lead a project utilizing Seattle Genetics’ new data analytics her master’s thesis at UW, she platform to conduct health economics and outcomes research used IBM MarketScan Databases using claims and electronic health record data. The project will to assess adherence, healthcare resource utilization, and costs support HEOR evidence generation for a Seattle Genetics late- among patients treated with antidepressants. Additionally, stage asset. In the fall, she will be working with Shelly Gray’s she presented work in collaboration with UW and Fred Hutch alzheimers research, in developing a research plan to use Adult faculty as a poster at the AMCP Nexus 2018 Meeting and a Changes in Thought (ACT) data to examine the association forum presentation at the ISPOR 2019 Annual Meeting. Jamie is between anticholinergics and physical performance. excited to join the Allergan team and apply her training at UW to support pipeline and marketed products at Allergan. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 17


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    CURRENT STUDENTS AND FELLOWS continued Wei-Jhih Wang, MS, Sabra Zaraa, PharmD, PhD Student MPH, PhD Student Wei-Jhih is beginning year five Sabra is beginning her second of her PhD program with the year of the PhD program, CHOICE Institute. She sucesffuly after joining us from the UW defended her dissertation department of Global Health proposal this past year, which where she earned her MPH as a is titled Mimicking clinical trials Fulbright scholar. She has been using real-world data - A novel working with the Institute for method and applications. This Health Metrics and Evaluation past year Wei-Jhih worked with since starting with CHOICE, which Professor Anirban Basu as a has enabled her the opportunity Research Assistant on the Value to collaborate on many cutting of Information project. She presented two posters at ISPOR edge projects, including developing a frailty index for the IHME in New Orleans, “ A Novel Method for Assessing Feasibility Antimicrobial Resistance, Global Burden of Disease project with of Generating Real-World Data Based Control Groups” & Georgios Kotsakis. Sabra serves as the project’s data analyst “Assessing the Generalizability of Clinical Trials Without for this project and their work is contributing to capturing Individual-Level Trial Data”. This summer, Wei-Jhih is working the burden of disease in older populations globally. She has with Genentech’s technical institute team in San Francisco as also been working with the Saudi Arabian Ministry of Health, an intern. The summer internship provided her with a better conducting readiness and service availability assesments of understanding of HEOR from an industry perspective, and it hospitals and health centers which serve pilgrims in Mecca, was a great opportunity to learn how to link academia work Saudi Arabia. Sabra was co-PI of a grant awarded for UW to the industry setting. For the upcoming year, Wei-Jhih is Population Health to study integrated care models for people planning to keep working on her dissertation and graduate. living with epilepsy (highlighted later in this report). She looks She will also continue working, present at conferences, forward to continung her work in year two of the PhD program, and finish several projects with CHOICE faculty, including as well as narrowing in on a dissertation topic. examining the availability of clinical trials with Aasthaa Bansal and meta-analyzing count events over time using convoluted Poisson model with Anirban Basu. 18 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    CURRENT POST-DOCTORAL FELLOWS Kritee Gujral, MA, PhD Aig Unuigbe, Kritee joined the CHOICE institute MA, MPhil, PhD. as the NHLBI senior post-doctoral Aig is currently the Pfizer Senior fellow in May 2018. She completed her Postdoctoral Fellow. During his first Ph.D. in Economics at the University year at CHOICE he has collaborated of Florida, and holds undergraduate with colleagues at the Institute degrees in Mathematics and on projects evaluating varying Economics, with minors in Statistics propensity score methods and and Religion. Prior to arriving at UW, on approaches to reconcile cost she worked as a transfer pricing tax effectiveness methods such as analyst in San Jose, CA. She has also Augmented Cost Effectiveness worked as a researcher at the Institute of Child Health Policy Analysis (ACEA) and Multi-Criteria Decision Analysis. He has in Gainesville, Florida and in the non-profit sector in Mysore, also engaged in research exploring the factors related to the India, estimating corruption-related leakages in the state’s food life cycle of products in the generic drug market. In addition, subsidy system. Kritee is passionate about contributing to societal he has continued existing work exploring the impact of improvements and having real-world policy impact. health policies on the behavior and financial outcomes of individuals and households. He has enjoyed interacting with Her primary research interests are Applied Microeconomics, the faculty and students at the Institute and learning more Public Economics, Health Economics, Bargaining and Online about their diverse research interests. Markets. Her Health Economics research identifies channels of improvement in healthcare service delivery. This past year, Aig will spend the second year of the fellowship at the her research focused on analyzing racial disparities in diabetes Pfizer New York City campus where he will work on real outcomes, and the adverse impact of rural and urban hospital world data analysis questions and other projects under the closures on patient mortality. Her work was presented and supervision of his mentor Cristina Masseria. He will also appreciated at the VanHEM 2019 conference. During this year, continue his research on propensity score methods and she also trained in Value of Information (VOI) analysis and seeks other collaborations with colleagues at the CHOICE Institute. to apply these methods for better healthcare decision-making. He is looking forward to this transition. She also aims to build on her prior work by studying the impact of health system changes, such as hospital closures and mergers, for other vulnerable populations. . UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 19


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    2019 CHOICE ANNUAL RETREAT: STRATEGIC THINKING In May, CHOICE faculty, students, and staff gathered at the Washington Park Arboretum for our annual retreat. This retreat is a unique opportunity to take a break from our busy schedules, spend the day together, and put forth a focused effort on reflecting and looking ahead as an Institute. This year’s theme was “Strategic Thinking”, aligns with our and are teaching a curriculum for this bootcamp over the upcoming 10-year graduate program review. Dean Sean summer for our new industry fellows. We look forward to Sullivan provided a history of CHOICE/PORPP and updated us utilizing and improving this as a regularly offered resource about the School of Pharmacy’s strategic plan process. This led for new students. Our strategic plan will be finalized and us into one of our main activities of the day, a SWOT Analysis. published in the fall on our website. We split into groups based on those four categories: Strengths, We also hosted an invited guest speaker: Career Coach, Weaknesses, Opportunities, Threats. Elizabeth Atcheson, who gave a presentation on Career Having all hands-on deck working through this was incredibly Planning and Strategy, an identified student need. This was valuable to the finalization of our strategic plan and some another theme that had arisen as a student need during our issues are already being addressed and ideas being put into strategic planning efforts. motion. One identified need was for a claims data and R By mid-afternoon, we were ready to get moving. Fortunately, coding bootcamp that would take place over the summer, so our outstanding retreat committee members Enrique and Lizzy new students can be brought up to speed before beginning had an HEOR photo scavenger hunt planned for us. How else their studies. In response, three PhD students have created 20 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    could a health economist enjoy a botanical garden, but to do so while acting out “moral hazard” and “diminishing returns” in photo form? To end the day we enjoyed some delicious tacos from Taqueria Los Chilangos at our social reception. Thanks to all whose families, friends, partners, and dogs were able to join us for the fun! It was certainly a day to remember and couldn’t have been the success it was without the efforts of the retreat planning Committee: Josh Carlson, Marina Gano, Lizzy Brouwer, and Enrique Saldarriaga. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 21


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    2ND ANNUAL CHOICE INSTITUTE ANNUAL SYMPOSIUM In March, we were fortunate to welcome Professor Emeritus Charles E. Phelps, PhD, for our annual symposium. Dr. Phelps provided an overview of multiple-criteria decision analysis (MCDA) methods. He discussed how to use MCDA in a budget- constrained decision context, and demonstrate potential uses for individuals. The seminar concluded with an exercise using alternative group choice mechanisms and a discussion of their merits. We enjoyed a reception following the symposium with good food and company. Charles E. Phelps started his career at the RAND Corporation, working from 1971-1984, when he joined the University of Rochester as a professor and director of the public policy analysis program. He later became the provost of the University of Rochester until his retirement. He is an expert on health and health care economics. Dr. Phelps met with our students during his visit, a fantastic opportunity for them to network with and engage in discussion with such a leader in our field. Thank yous go out to Professor Emeritus Lou Garrison for helping coordinate Dr. Phelps’ visit in Seattle and of course to Dr. Phelps himself. We look forward to our third symposium next year as we continue to develop this annual event! “The CHOICE Institute was delighted to host Professor Emeritus Charles Phelps as the keynote speaker for the CHOICE Annual Symposium. Professor Phelps discussed alternative methods and challenges to conduct multi-criteria decision analysis and took the audience through a hands-on exercise. Understanding these tools is important for engaging with health technology assessment bodies and helping them develop a transparent assessment process when desired.” ANIRBAN BASU, PROFESSOR AND STERGACHIS FAMILY ENDOWED DIRECTOR, THE CHOICE INSTITUTE. 22 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    EXPANDING OUR INDUSTRY PARTNERSHIPS THROUGH TRAINING PROGRAMS This has been an exciting year for our PharmD/MS industry As our network of alumni grows, as does our distinction as a fellowship programs. What once began as one Allergan leader in health economics and outcomes research training and fellowship per year, has expanded tremendously and for the graduate education. We are thankful for the strong partnerships better. This year we are pleased to unveil our Seattle Genetics maintained through these training programs. We are committed PharmD/MS fellowship program and our largest PharmD/MS to ensuring a quality experience for our fellows and to recruit fellow cohort yet. We now have fellowship programs with the top candidates. We have newly appointed Dr. Ryan Hansen, following companies: PharmD, PhD, as the Director of Industry Fellowships. This is an important new role which will contribute to the success of • Allergan (2 fellows) our fellowship programs and industry partnerships. We look • Bayer (1 fellow) forward to seeing the meaningful work Dr. Hansen will do in this • Genentech (2 fellows) role in the upcoming year. • Seattle Genetics (1 fellow) THE 2018-2020 PHARMD/MS FELLOWS TAKE A SELFIE IN RED SQUARE. DR. RYAN HANSEN WITH BAYER PHARMD/MS 2ND YEAR FELLOW, TOM HOPKINS. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 23


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    FACULTY HIGHLIGHT: RYAN HANSEN CHOICE Institute Assistant Professor Ryan Hansen PhD, PharmD has enjoyed a broad research portfolio since he joined our faculty in 2012. Dr. Hansen’s research has focused on Comparative Effectiveness, Safety, and Value evaluations, publishing over 50 peer-reviewed manuscripts in this area of research. His work in comparative effectiveness has spanned a broad range of clinical areas including neurology, solid organ transplant, post-surgical pain, chronic pain, dentistry, pulmonology, and oncology. Dr. Hansen’s value assessment portfolio has included cost-effectiveness, burden of illness, and budget impact analyses across many clinical areas. This past year he joined the UW collaboration with the Institute for Clinical and Economic Review, and serves as the lead investigator of a research team with Dr. Greg Guzauskas. This team most recently has focused on modeling new treatments for peanut allergy and also a novel oral treatment for insulin dependent diabetes mellitus. Dr. Hansen’s research program has continued to curate a 15- year longitudinal database of motor vehicle crashes from the Washington State Department of Transportation linked with Kaiser Washington medical records in order to evaluate the associations between motor vehicle crashes and both medical conditions and medications. Motor vehicle crashes remain a In addition to serving on our faculty, Dr. Hansen is also a constant public health threat, and one that is influenced greatly practicing pharmacist and has leveraged his experience in by medical conditions and pharmaceutical treatments. In the community pharmacy to collaborate in research that evaluates U.S. alone there are over 6.4 million crashes per year, causing innovative approaches to improve the health care system. Dr. over 40,000 deaths and an overall cost of approximately $871 Hansen recalls that his first experience with pharmacy practice billion dollars per year. Along with collaborators from the Kaiser research came through a collaboration with Drs. Beth Devine Permanente Washington Health Research Institute, including and Tom Hazlet, evaluating medication errors associated with Drs. Sascha Dublin and Gaia Pocobelli, statisticians Mary the implementation of electronic prescribing. Since then, Dr. Akosile and Robert Wellman, Dr. Hansen recently completed an Hansen has been involved in evaluations of novel risk reduction evaluation of the association between obstructive sleep apnea initiatives to increase access to naloxone among individuals and crashes. at risk of an opioid overdose, and also, in collaboration with Department of Pharmacy Faculty Dr. Jennifer Bacci and Dr. Peggy Odegard, and CHOICE Faculty Dr. Andy Stergachis, an evaluation of a new approach to increasing rates of adult immunizations through access at community pharmacies. Additionally, over the past two and a half years, Dr. Hansen has served as the Faculty Director of the UW Rubenstein Memorial Pharmacy at the UW Hall Health Primary Care Center. In this administrative role he provides leadership and oversight to the primary on campus pharmacy that serves our UW students, faculty, and staff. 24 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    “When I was still struggling to articulate my dissertation aims, I started meeting with Ryan to discuss some abstract ideas. Ryan made time to meet with me weekly in order to flesh out those ideas into concrete dissertation aims, in addition to suggesting other faculty and professionals that might assist in my dissertation development. His feedback consistently pushed me to think more critically while still validating and celebrating my ideas. These low-pressure weekly conversations were an invaluable source of confidence and motivation in moving my dissertation forward. He goes above and beyond what is expected to help students navigate the academic portion of their careers.” ELIZABETH BROUWER, 5TH YEAR PHD STUDENT Dr. Hansen is also a respected mentor to our graduate students, being nominated this year for the School of Pharmacy Outstanding Mentor Award. Although he was not selected, this speaks volumes to the impact he has on students. Thank you, Dr. Hansen, for enriching the student experience and inspiring growth through your mentorship. “Ryan is a skilled mentor. He is extremely available and open, providing a solid balance of advising and support while encouraging independent thought. He also goes above and beyond to connect students to valuable resources.” – Lauren Strand, 4th year PhD student. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 25


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    HEALTH ECONOMICS PACIFIC NORTHWEST CERTIFICATE PROGRAM EVIDENCE BASED PRACTICE UPDATE CENTER (PNW EPC) The Certificate in Health Economics and Outcomes Research Beth Devine and John Gore are the Assistant Directors and site program is entering its 8th year. Last academic year featured principal investigators of the AHRQ-funded Pacific Northwest two separate cohorts, including a large group of health Evidence-based Practice Center (PNW EPC) who, along with Paul ministry students from Saudi Arabia. Launched at the start Kraegel, UW EPC Program Manager, coordinate EPC projects of the 2012-2013 academic year in conjunction with the UW across the three partner institutions: Oregon Health & Science Professional and Continuing Education program, the distance University, the University of Washington CHASE Alliance, and learning program has trained over 400 students in a wide Aggregate Analytics, Inc. The UW joined the EPC program range of health care settings including payer organizations, in 2013 and to date has participated in seventeen projects health insurance industry, government, pharmaceutical and and twenty-five associated publications. The projects range biomedical industries. The program offers one course per in scope from evaluation of medication-assisted treatment academic quarter: programs to risk assessment, genetic counseling, and genetic testing for BRCA–related cancer. One current project features a large systematic review of opioid treatments for acute pain. • Fall quarter: Principles of Health Economics, taught by Lou Another project is updating a systematic review on the topic of Garrison and Anirban Basu noninvasive nonpharmacological treatments for chronic pain. • Winter quarter: Economic Evaluation, taught by Dave Since joining the EPC, the UW has received over $1.5 million in Veenstra and Josh Carlson flow-through funding from AHRQ. Numerous CHOICE faculty have led and participated in EPC projects. These include Joseph • Spring quarter: Practice of HTA in a Global Environment, Babigumira, Josh Carlson, Ryan Hansen, Scott Ramsey, Sean taught by Sean Sullivan and Beth Devine. Sullivan, and numerous colleagues from the UW Schools of Medicine and Public Health. During the program, students learn the key economic concepts and analytical tools of human economic behavior, explore state-of-the-art economic evaluation of health care technologies, and are introduced to the principles and methods of HTA practice. Students work in groups throughout the program on a capstone project, which applies their learning to an assigned country. Student evaluations have remained positive over the years. Applications have routinely been 40+ since the beginning of the program. The program also has an active LinkedIn alumni group. Courses are continually being updated and revised to keep pace with changing technologies and economies. Revenues from the Certificate in Health Economics and Outcomes Research program support 1-2 CHOICE teaching assistant positions each year. 26 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    CHOICE AND ICER COLLABORATION 2019 UPDATE The University of Washington School of Pharmacy (UWSOP) Greg Guzauskas presented work done with Ryan Hansen at the and the Institute for Clinical and Economic Review (ICER) California Technology Assessment Forum (CTAF), in Oakland, formed a partnership in 2016 leveraging UWSOP’s expertise CA. Their work provided estimates for the annual cost at which in economic modeling of pharmaceutical interventions to two immunotherapies (AR101 and Viaskin® Peanut) would support ICER’s growing body of work in new drug assessments. reach cost-effectiveness thresholds ranging from $50,000 to The current UW team is comprised of faculty (Josh Carlson $150,000 per QALY gained compared to peanut avoidance alone. (PI), David Veenstra, Anirban Basu, and Ryan Hansen), and Based on analysts’ estimated prices, AR101 was estimated to be staff scientists (Greg Guzauskas and Lisa Bloudek). To date we cost-effective while the incremental cost-effectiveness ratio for have completed or are working on economic evaluations on Viaskin Peanut fell above the $150,000 per QALY threshold. In a 12 topics: peanut allergy (2019), multiple myeloma (2016), non- scenario analysis considering societal costs, both may be cost- small cell lung cancer (2016), 2 in plaque psoriasis (2016 and effective versus peanut avoidance. Ultimately, the long-term 2018), relapsing remitting multiple sclerosis (2017), secondary cost-effectiveness of AR101 or Viaskin Peanut is dependent on progressive multiple sclerosis (2019), atopic dermatitis the prices at which they come to market. (2017), osteoporosis (2017), RPE65-mediated inherited retinal In summary, our collaboration with ICER continues to yield disease (2018), Hemophilia A (2018), prostate cancer (2018), positive returns in terms of research productivity, contributions and hereditary angioedema (2018). Our work has been to timely and impactful conversations about the value of disseminated at ICER public meetings, as part of ICER’s full topic emerging products in the U.S., and a voice in the continuously reports, in conference proceedings (6 abstracts), and in peer evolving discussion about how to best measure the value for reviewed journals (5 published, 2 in development). money of innovative medical and pharmaceutical treatments. In our two most recent evaluations, we presented on We are looking forward to evaluating the model transparency siponimod for secondary progressive multiple sclerosis effort, as well as developing and testing alternative approaches and technologies to induce immune tolerance immunology to measuring health outcomes. as treatments for peanut allergy. These reviews included our model validation and transparency program where manufacturer stakeholders are able to review and provide comments on the model during the ICER draft report review period under a limited usage agreement. For the siponimod analysis, Lisa Bloudek presented work done with Josh Carlson at the Midwest Comparative Effectiveness Public Advisory Council (CEPAC) in Chicago, IL . They found that it was not cost-effective versus no treatment in the base case for the overall population of patients with secondary progressive multiple sclerosis, nor in the subgroup of patients with relapses in the past 2 years—a proxy for active secondary progressive multiple sclerosis. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 27


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    2019 BRAMS UPDATE When the Master of Science in Biomedical Regulatory Affairs (BRAMS) program launched in 1998, the intended applicant pool was healthcare industry quality/regulatory professionals interested in a part-time, in-person, evening program. It soon became clear that a full-time option was necessary, both permitting students to specialize in an area of interest through additional courses, e.g., Chemistry, Manufacturing and Control (CMC) statistics, pharmacoepidemiology, medical biometry, and satisfying visa requirements for international students. BRAMS has received STEM (science, technology, engineering, and mathematics) designation, allowing qualified F-1 holders to participate in optional practical training (OPT). The full-time, Applied, program was approved in 2018 and the first full-time student graduated this year. Thirteen students graduated with a master’s degree from the BRAMS program in the 2018-19 academic year. Their practicum topics included: • Strategic regulatory development plan for clinical trial • Development of an informed consent form in compliance transparency activities with the University of Washington Institutional Review Board requirements • Development of an eCopy style guide and regulatory intelligence repository for Premarket Approval submissions • Annual review of commercial product investigator’s brochure, product-level, and study-level documents • Development of an IRB application for an industry- sponsored cardiology clinical trial • Improving the informed consent and promotional material of an observational study involving vulnerable populations • Updating post market surveillance processes for a device company: Compliance with EU MDR Regulation (EU) 2017/745 • Regulatory practices associated with post-Premarket Approval product changes • Transitioning from paper Investigational New Drug submissions to the electronic Common Technical • Review of the UW Biomedical Regulatory Affairs Master of Document format Science (BRAMS) program • Identifying requirements for an Investigator-initiated IND • Establishing a pathway and communicating with FDA for a submission and a pre-IND meeting for a vaccine novel cell therapy • Comparing the application requirements and processes for initiating clinical trials between the United States and Belgium. With BRAMS’ STEM approval, most of the international students have begun taking advantage of local industry “Curricular Practical Training” internship opportunities. BRAMS has received repeated requests for an on-line version and the Statistical Topics for Biomedical Regulatory Affairs Professionals will be available on-line for the Winter 2020 session. 28 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    FACULTY HIGHLIGHT: ZACHARY MARCUM Dr. Marcum was recently awarded the Paul B. Beeson Emerging This research is important as there are currently no disease- Leaders Career Development Award (K76) from the National modifying treatments for dementia. Finding preventative Institute on Aging (NIA) and The John A. Hartford Foundation. therapies like these already-approved medications may help Dr. Marcum is the first pharmacist to receive the grant, which stave off dementia and could offer a new preventative option is typically awarded to physician-investigators. This initiative is for people at risk for dementia. focused on clinically trained, early-stage investigators who take This 3-year, approximately $700,000 grant, will investigate the an active leadership role in creating transformative changes association between long-term antihypertensive use and brain that will lead to improved health care outcomes in the field of health, including Alzheimer’s disease and other dementias. aging and geriatrics research. Congratulations Dr. Marcum! Zach’s research looks at whether certain blood pressure medicines are protective against dementia. Mounting evidence suggests that certain antihypertensives may reduce one’s risk of dementia if taken during mid-life. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 29


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    FACULTY HIGHLIGHT: AASTHAA BANSAL SUPPORTING CANCER SURVIVORS Aasthaa Bansal is leading an interdisciplinary team to carry out research and create tools that seek to shift the paradigm for how routinely-collected patient information is used for clinical management, by innovatively coupling data-adaptive prediction modeling with statistical decision theory. This decision-making framework will evaluate the value of Current guidelines recommend frequent testing in most cancer future clinical information and guide patient-level decisions settings. However, frequent testing involves trade-offs. Many about the optimal frequency of surveillance testing, while patients are at low risk of experiencing recurrence, and the taking into account a patient’s evolving risk of recurrence. complications and costs of frequent tests are not justified for “As a patient’s information changes, if they go from low to these patients. Experts have cautioned against over-testing high risk, for example, their follow-up recommendations and advocated for risk-based strategies using the personal will also be updated in this dynamic decision-making clinical history of each patient to provide better tailored care framework,” said Aasthaa. to cancer survivors. Although there is growing recognition that a one-size-fits-all strategy of frequent patient visits may Despite receiving effective primary treatment, many cancer be suboptimal, there is ambiguity regarding how best to tailor survivors remain at risk of relapse and associated morbidity surveillance to individual cancer survivors. and mortality. Surveillance testing using biomarkers and imaging may detect disease recurrence before clinical symptoms manifest and allow for early treatment. “As more people beat cancer, providers need better tools to help them understand the relative costs and benefits of alternative surveillance strategies and provide more personalized follow-up care to cancer survivors.”— Associate Professor Aasthaa Bansal, The CHOICE Institute Her team includes CHOICE Professors Anirban Basu and David Veenstra, as well as researchers from UW Biostatistics and Medicine, Fred Hutch, and Kaiser Permanente Southern California (KPSC). The framework will be implemented on electronic health record data from KPSC, utilizing rich patient-level information, such as disease history, lab results, and comorbidities in order to inform risk and guide decision-making, which could lead to major advances in personalized medical decision-making. The focus of this grant will be to apply the framework to colorectal cancer, prostate cancer and chronic myeloid leukemia. However, the ASSOCIATE PROFESSOR AASTHAA BANSAL PHOT CREDIT:ALEX LEVINE 30 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2018 2019 ANNUAL REPORT


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    general methodology developed by the research team could investigators whose research competence and productivity be applied to any disease setting where ongoing surveillance are distinctly superior and who are highly likely to continue is a major component of patient care. “We are creating an to perform in an outstanding manner, according to the NIH. approach that we plan to extend to other diseases, including In 2016 and 2017, only eight MERIT awards were granted each pediatric cancers, where similar open questions exist,” year across all of NIH. reflected Aasthaa. The National Cancer Institute of the National Institutes of The NIH deemed her project so significant, they granted the Health funded this R37 grant (1R37CA218413-01A1) for $2.2M. team $2.2M for 5 years and up to 2 additional years of funding through a Method to Extend Research in Time (MERIT) Award. MERIT Awards provide long-term grant support to 1 UNIVERSITY OF OF W WAASHINGTON SC SCHOOL O OFFP PHHARMACY 31


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    UW CHOICE HEALTH TECH FUND (HTF) PROJECT 2019-2021 The University of Washington School of Pharmacy This year’s Health Tech Fund Project: The Impact (UW SOP), in partnership with our Corporate Advisory of Real-World Evidence on Health Technology Board (CAB), launched the Program in Policy Research Assessments and Its Value to Payers was funded with for Health Technologies (Health Tech Fund) in 2007 as a support from 15 industry partners. The Food and Drug public-private collaboration designed to fulfill the CHOICE Administration (FDA) released guidance in June 2018 on Institute’s mission; and to respond to industry interests how the pharmaceutical industry may communicate in value-based benefit design, coverage, reimbursement, health care economic information (HCEI) and real world and product valuation for the medical products industry. evidence (RWE) to payers. By placing a focus on the role The ultimate goal of the Health Tech Fund is to further of RWE in informing payers’ decision making, it is likely to the mission of CHOICE. Since 2007, Health Tech Fund encourage companies to communicate more data about projects have evaluated performance-based risk sharing the “real-world” impact of drugs. The goal of this project agreements, the value of HEOR, paying for cures, and is to examine the impact RWE has in health technology quality and prioritization of evidence; 14 papers have been assessments (HTA) in the US and the value payers published and 12 graduate students and post-docs have place on RWE within the context of HTA. The impact been supported. of this work will include providing HEOR groups with a better understanding of the landscape of RWE within the context of HCEI communication, insight regarding the impact and value of RWE in the marketplace, and a framework to communicate the value of RWE internally. 32 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    PHENOM SEMINAR The Program in Health Economics and Outcomes Methodology (PHEnOM) at The CHOICE Institute is a joint program with the Department of Health Service in the School of Public Health. The program aims to facilitate intellectual activities within the departments in the fields of health economics, econometrics and methodology development in outcomes research and to engage researchers in allied fields around the city of Seattle. This year we are excited to have Drs Doug Barthold and Jerome Dugan take the lead in organizing this seminar series as co- Directors. We look forward to what they have in store for us! Doug Barthold, PhD, joined CHOICE in 2018 as a Research Assistant Professor. He came to us from the University of Southern California where he was a post-doctoral scholar with the Schaeffer Center for Health Policy and Economics. Dr. Ellen J. Bass, Professor and Chair of the Department of Doug received his BBA in Health Systems and Sciences Research in the College of Nursing Management, Economics and and Health Professions at Drexel University. Dr. Bass also holds Mathematics in 2007 from the a joint appointment in the Department of Information Science University of Massachusetts, in Drexel University’s College of Computing and Informatics. Amherst, MA and then received She also holds affiliate status in Drexel University’s School of his PhD. in Economics in 2015 at McGill University in Montreal, Biomedical Engineering, Science and Health Systems. Bass QC. Doug is interested in the relationships between health has over 30 years of human-centered systems engineering policies, health care utilization, and health outcomes, especially research and design experience in multiple domains including in the pharmaceutical sector. air transportation and health care. Jerome Dugan, PhD, is an The focus of her research is to develop theories of human Assistant Professor in the performance, quantitative modeling methodologies, and department of Health Services. measures that can be used to evaluate human-automation He is the Leo Greenawalt interaction and human-human coordination in the context of Endowed Assistant Professor total system performance. Bass holds a Ph.D. in Industrial and in Health Policy. He came to us Systems Engineering from the Georgia Institute of Technology, from Drexel University, where an M.S. in Advanced Technology from the State University of he was an Assistant Professor. New York at Binghamton, a B.S.Eng. in Bioengineering from the He got his PhD in Economics University of Pennsylvania, and a B.S.Econ. in Finance from the from Rice University. His interest are in health insurance University of Pennsylvania. status and the organization of Dr. Bass will be presenting at PHEnOM on Wednesday, the healthcare system impacts October 30, 2019, at 3:30 pm in the Dept of Pharmacy on healthcare cost and quality. Conference Room, H371. As first order of business, Dr. Barthold and Dr. Dugan are excited to introduce one of the first speakers for the seminar series for the year ahead: UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 33


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    ISPOR UPDATE Thank you to all those who joined us in New Orleans at our annual social reception! It was so great to connect with alumni and friends. We had great representation at ISPOR this year by CHOICE students, faculty, and alumni. Our connection with ISPOR is not limited to attending conferences. We have an active student ISPOR chapter. We thank Erik Landaas for his great work leading the chapter in 2018-19 and are pleased to welcome incoming president, Enrique Saldarriaga. With that said, here are some highlights from the May conference and our social reception. See you in Orlando in 2020! Short Courses: Panel sessions: Risk Sharing/Performance-Based Arrangements for Drugs The Controversial QALY: Is There a Middle Ground and Other Medical Products in the Debate? Faculty: Louis P. Garrison, PhD, University of Washington, Moderator: Jennifer Bright, MPA, Innovation and Value Initiative, Seattle, WA; Adrian Towse, MA, MPhil, Office of Health Alexandria, VA Panelists: Lou Garrison, PhD, University of Economics, London, UK; Josh Carlson, MPH, PhD, University of Washington, Seattle, WA ; Eleanor M. Perfetto, PhD, MS, National Washington, Seattle, WA Health Council, Washington, DC; Anna Kaltenboeck, MA, Memorial Sloan Kettering Cancer Center, New York, NY A Health Economics Approach to US Value Assessment Frameworks Net Health Benefit” - Asco vs. I.C.E.R. Value Frameworks: Are Faculty: Richard J. Willke, PhD, ISPOR, Lawrenceville, NJ; Louis P. We Talking About The Same Thing? Garrison, PhD, University of Washington, Seattle, WA ; Charles Podium Presentation by Jamie Ta, UW/Allergan E. Phelps, PhD, MBA, University of Rochester, Gualala, CA Postdoctoral Fellow ISPOR Health Preference Methods Special Interest Group: Tools for Reproducible Real-World Data Analysis (NEW) Frontiers in Health Preference Research Faculty: Carrie Savage Bennette, MPH, PhD, Flatiron Health, Seattle, WA; Blythe Adamson, PhD, MPH, Flatiron Health, New Real Option Value for Drugs: Is It Really an Option? York, NY; Joshua Kraut, MS, Flatiron Health, Seattle, WA Moderator: Adrian Towse, MA, MPhil, Office of Health Economics, London, UK Cost-Effectiveness Analysis Alongside Clinical Trials Panelists: Meng Li, PhD, ScM, University of Southern California, Faculty: Scott D. Ramsey, MD, PhD, Fred Hutchinson Cancer Los Angeles, CA; Jens Grueger, PhD, University of York, Research Center and University of Washington, Seattle, WA; Heslington, York, UK Richard J. Willke, PhD, ISPOR, Lawrenceville, NJ Educational Symposium: The Evolution of HTAs: What Matters Most? Sponsored by: Amgen Moderator: Anusha Kheir, MPH, Amgen, Thousand Oaks, CA, Speakers: Louis P. Garrison, PhD, University of Washington, Seattle, WA; Felicity McNeill, PSM, Hepatitis Australia, Woden, ACT, Australia; Gordon G. Liu, PhD, Peking University, Beijing, China 34 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    STUDENT HIGHLIGHT: LAUREN AND NATHANIEL NATHANIEL HENDRIX 2019 Recipient of the UW School of Pharmacy, Outstanding Student Leadership Award Nathaniel is a fifth-year PhD candidate at The CHOICE Institute, which he joined after completing his PharmD at UW. His dissertation is on using the tools of health economics such as outcomes modeling, and discrete choice experiments to solve translational issues around the integration of artificial intelligence-based tools into clinical practice, and using big data to estimate resource use. Nathaniel’s other research interests include attitudes toward uncertainty in diagnostics and personalized medicine and improving the cost-effectiveness of cancer screening. Nathaniel is a natural leader and scholar. He has organized and trained for junior students in cost- effectiveness modeling and claims analysis, has received two T32 training grants, a pre-doctoral fellowship in outcomes research from The PhRMA Foundation, and is the 2019 recipient of the the UW School of Pharmacy’s Outstanding NATHANIEL HENDRIX, PHARMD, PHC Student Leadership award. In addition to his studies, Nathaniel has worked as a health economics consultant for the pharmaceutical industry, professional organizations, and use this as an opportunity to create a blog of our own. My goal global health non-profits. in doing this was to provide a platform for students to share insights from their own work, provide tutorials on methods Nathaniel’s dissertation chair, Dr. Dave Veenstra, was one that they were learning, and comment on aspects of student of his nominators for the leadership award. Dave notes that life in a health economics program. With the help of several Nathaniel is extremely bright, creative, and productive. Of collaborators, I launched the blog in January 2018.” -Nathaniel Nathaniel, he highlights how he “identified his dissertation Hendrix, PharmD, PhC topic on the use of AI in breast cancer screening on his own, reached out to collaborators at Kaiser and SAGE Bionetworks, Graduate program director, Dr. Beth Devine, reflected on the and recruited a robust dissertation committee. He also served important role Nathaniel plays as a leader among our students. as the primary cost-effectiveness modeler for a national He is a go-to-person when a new perspective is needed to tackle technology evaluation with ICER, a position typically reserved research questions and he is always eager to brainstorm with for senior scientists.” his colleagues and peers. Nathaniel utilizes his own experiences to support his fellow students to advance their careers. As a One of Nathaniel’s greatest contributions to the CHOICE recipient of the PhRMA Foundation Pre-Doctoral Fellowship in Institute is his founding of the CHOICE student blog, Health Outcomes in 2018 he helped several student colleagues Incremental Thoughts. develop their applications this year. “Many of the most important conversations in health In summary, Nathaniel has been a tremendous asset to the economics now take place online. As I began to learn enough CHOICDE PhD program, and an exemplary student leader. about our field to participate in some of these conversations, He combines curiosity about research methods with a devotion I saw the influence that an active online presence can to helping those around him develop as scholars. Nathaniel have. Through Twitter, blogs, and other social media, I saw plans to defend his dissertation and graduate this upcoming researchers expanding the reach of their work by offering academic year. brief, reader-friendly summaries of their publications and commentaries on others. This is why, when I became president Check out how Nathaniel’s contribution keeps growing, at our of our ISPOR student chapter during my third year, I decided to student blog, Incremental Thoughts: https://choiceblog.org/ 36 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    LAUREN STRAND Named 2019-2020 UWSOP Magnuson Scholar Congratulations to third-year PhD student in the CHOICE She will focus on putative “substitutable” classes of drugs such Institute, Lauren Strand who was named the UWSOP as opioids. If there is evidence of substitution occurring over Magnuson Scholar for 2019-2020. Magnuson Scholars are time, for future study she is interested in how such real-world selected for their excellent academic performance and patterns of prescription drug substitution could relate to outstanding potential for research in the health sciences; negative overdose outcomes such as hospitalization and death. they receive $30,000 to support their research, education, While this research area is challenging and fast-paced, she and training. hopes her findings might help inform future initiatives in Originally interested in studying prescription drugs of potential Washington and other states. abuse from the public health perspective, Lauren has become We are so proud of you, Lauren! Congratulations on this fascinated by the economic underpinnings of prescription significant award and recognition for your research. drug use and abuse. For her dissertation, she will investigate the relationship between recreational cannabis policy/roll-out and prescribing in the state of Washington and in several other legalizing states. MAGNUSON SCHOLAR LAUREN STRAND WITH CHOICE FACULTY (RIGHT TO LEFT) RYAN HANSEN, JOSH CARLSON, AND BETH DEVINE UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 37


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    LOUIS SR. AND MARILYN GARRISON ENDOWED PRIZE IN HEALTH POLICY AND ECONOMICS Congratulations to the 2019 winners of the Louis Sr. and Marilyn Garrison Endowed Prize in Health Policy and Economics, Elizabeth Brouwer (4th year CHOICE PhD student) and Gilbert Ko (3rd year PharmD/MBA student)! CHOICE Professor Emeritus, Dr. Lou Garrison, is seen here presenting Lizzy with the award, named in honor of his parents, at the CHOICE Annual Retreat. This year’s prize was awarded to both Lizzy and Gilbert for their impressive papers: “Implicit Adoption of Cost-Effectiveness- driven Value-Based Formularies in Private Health Insurance 2010-2013,” authored by Elizabeth D. Brouwer, Anirban Basu, John Watkins, Kai Yeung and Gilbert’s paper, “Gene Therapy for Hemophilia A: Value-Based Pricing.” Congratulations, Gilbert and Lizzy! 38 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    BACCI, WHITE, AND ZARAA AWARDED UW POPULATION HEALTH GRANT TO STUDY INTEGRATED CARE MODELS FOR PEOPLE LIVING WITH EPILEPSY Congratulations to Jennifer Bacci, Assistant Professor, population level, community pharmacists collaborate with Department of Pharmacy; H. Steve White, Professor and Chair, other healthcare providers and assess medication use patterns Department of Pharmacy; and Sabra Zarâa, CHOICE PhD and patient outcomes data to ensure medications are used student, Pharmacy on receiving one of the 2019 pilot research effectively, safely, and in a cost-effective manner. No models grants awarded by the UW Population Health Initiative. exist for engaging community pharmacists in population health The interdisciplinary team’s project is titled, “Community approaches to epilepsy care. pharmacist integrated population health management of This project seeks to develop a community pharmacist people living with epilepsy.” integrated population health intervention for people living with Epilepsy is a complex spectrum of seizure disorders, affecting epilepsy by (1) identifying best practices to address the needs approximately 3.4 million people nationally and 75,000 people of persons living with epilepsy and their caregivers; (2) develop in Washington state; and the number is increasing. It affects an intervention using a stakeholder driven and consensus quality of life and leads to significant health and socioeconomic building approach; and (3) evaluate the acceptability, disparities. The experiences of a person with epilepsy involves appropriateness, and feasibility of the intervention. The managing multiple co-existing health conditions and taking intervention developed from this project will be piloted and anti-seizure drugs, the mainstay of treatment that are often evaluated for effectiveness in future research. accompanied by significant adverse effects. Yet, healthcare and INVESTIGATORS: community services are often fragmented and uncoordinated. Jennifer Bacci, Assistant Professor, Department of Pharmacy Community pharmacists are among the most accessible and H. Steve White, Professor and Chair, Department of Pharmacy trustworthy healthcare providers with extensive knowledge Sabra Zarâa, CHOICE PhD student, Pharmacy of drug therapy, yet are seldom leveraged to fill the gaps in John Miller, Neurology and Neurological Surgery epilepsy care or many other non-communicable diseases. Edward Novotny, Pediatrics and Neurology Community pharmacists educate patients about their disease, Bryan Weiner, Global Health and Health Services ensure dosing accuracy, monitor for side effects and drug interactions, and encourage medication adherence. At a ASSISTANT PROFESSOR H. STEVE WHITE, SABRA ZARÂA, JENNIFER BACCI PROFESSOR AND CHAIR, CHOICE PHD STUDENT DEPARTMENT OF PHARMACY UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 39


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    ALUMNI UPDATES Blythe Adamson, ’18, MPH, PhD Carrie Bennette, ’15, MPH, PhD Business Insider named CHOICE alumna Blythe Adamson as Carrie was recently promoted at Flatiron Health in New York, one of 30 leaders under 40 transforming US healthcare. The list NY, to Principal Quantitative Scientist and is now leading the includes scientists, doctors, and entrepreneurs selected from quantitative scientists on the machine learning team. hundreds of nominations, based on their potential to improve healthcare nationwide. Mark Bounthavong, ’18, MPH, PharmD, PhD Data Pharmacist Program Manager, PBM VA Academic Detailing Services, San Diego, CA Health Economist, VA Health Economics Resource Center (HERC), Menlo Park, CA Research Affiliate, Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA. He and Dr. Emily Williams from Health Services also recently presented their preliminary results at the AcademyHealth 2019 Annual Research Meeting (ARM) of a study exploring how academic detailing may help reduce mortality in veterans prescribed opioids. After graduating from CHOICE in 2018, Adamson moved her family from Seattle to New York to join the health tech start-up company Flatiron Health. “I dragged my kids across the country so I could get access to this data,” Adamson, now a senior quantitative scientist at Flatiron, said. Dr. Adamson was recognized in Business Insider, the Washington Post, and more than 50 other press stories for her recent work as lead author on a study examining how the Affordable Care Act (ACA) affected racial equity in cancer care. The study, which sparked from a Flatiron hackathon project, found that ACA Medicaid expansion was associated with reduction in racial disparity in timely treatment of advanced cancer. The results were selected for Plenary presentation on the main stage at the American Society of Clinical Oncology (ASCO) 2019 Annual DR EMILY WILLIAMS, HEALTH SERVICES, AND MARK BOUNTHAVONG Meeting in Chicago. Congratulations, Blythe! PRESENTING AT ARM 2019 IN WASHINGTON DC. Adamson BJS, Cohen AB, Estevez M, Magee K, Williams E, Gross CP, Meropol NJ, Davidoff AJ. ACA and Medicaid Expansion Impact on Racial Disparity in Time to Cancer Treatment. Journal of Clinical Oncology 37(no. 18_suppl). DOI: 10.1200/ JCO.2019.37.18_suppl.LBA1. 40 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Jean Malacan, ’16, PharmD, MS Job change: started as Global HEOR Project Leader Oncology at Bayer on April 2019, based in Basel, Switzerland Presented at an issue panel at ISPOR annual meeting “Are standard HTA approaches to cost-effectiveness modelling appropriate for tumour-agnostic oncology products with basket trials?”. The panel was comprised of Jean, CHOICE affiliate faculty John Watkins (Premera), Richard Chapman (ICER), and moderated by Stacey Kowal (IQVIA). William Canestaro, ’17, MS, PhD William Canestaro, Managing Director at Washington Research Foundation, was selected as a 2019 “40 under 40” by the Puget Sound Business Journal. Will continues to collaborate with and support our students, faculty, and the institute through his work with the Washington Research Foundation. Congratulations, Will! PROFESSOR EMERITUS LOUS GARRISON, PHD STUDENT ERIK LANDAAS, AND ALUMNI BLYTHE ADAMSON, ’18, AND JEAN MALACAN, ’16, AT THE HTAI CONFERENCE IN COLOGNE, GERMANY. Nathorn (Nui) Chaiyakunapruk, ’01, PharmD, PhD Job change: began a new position as a Professor at the Devender S. Dhanda, ‘18, MS, PhD University of Utah, College of Pharmacy, Department of Current position: Worldwide HEOR Associate Director, Pharmacotherapy. Prior to this role, Nui has worked as an Bristol-Myers Squibb. Associate Professor at Naresuan University in Thailand and a Professor at Monash University Malaysia. Meng Li, ‘18, PhD, MS Current position: Postdoctoral Fellow, University of Southern California Schaeffer, Center for Health Policy & Economics, Los Angeles, CA Sara Higa, ‘18, PharmD, MS Current Position: Senior Manager, Global Health Economics and Outcomes Research, Allergan, Irvine, CA Chiemeka Ike, ‘18, MPH, PharmD, MS Current Position: Manager, Health Economics and Outcomes Research, Seattle Genetics UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 41


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    ALUMNI UPDATES continued Jean McDougall, MPH, PhD Veena Shankaran, ’12, MS, MD Former Postdoctoral Fellow, 2013-2016, funded by Fred Veena received Seattle Business Magazine Leaders in Health Hutchinson Cancer Research Center Care Gold Award: Achievement in Medical Research. In addition, she was recently appointed the new co-director of As an Assistant Professor in the Department of Internal the Fred Hutchinson Institute for Cancer Outcomes Research Medicine at the University of New Mexico, Jean’s research (HICOR). alongside CHOICE Adjunct Professor, Scott Ramsey, focuses on understanding the causes of financial hardship MD, PhD (director). In her new role, Veena will collaborate among cancer survivors and designing interventions to with Ramsey in strategic planning, scientific priority setting, address the financial consequences of cancer. Jean recently fundraising and organizational development. published a manuscript in the Journal of Cancer Survivorship about socioeconomic disparities in quality of life among cancer survivors. In addition, her work on food insecurity was featured Jonathan Watanabe, ’08, ’12, PharmD, PhD in a talk at the 2019 ISPOR conference in New Orleans and won Jonathan Watanabe was named this year’s UW Pharmacy a prize for best podium presentation. Alumni Association Distinguished Alumni Award Pharmaceutical Science and Research recipient. Jonathan McDougall, J., Blair, C., Wiggins, C., Goodwin, M., Chiu, V., was the original recipient of the prestigious UW/Allergan Rajput, A. and Kinney, A. (2019). Socioeconomic disparities in Post-doctoral Fellowship in Health Economics and Outcomes health-related quality of life among colorectal cancer survivors. Research. Jonathan received both an MS and PhD from Journal of Cancer Survivorship, 13(3), pp.459-467. CHOICE, formerly PORPP. His major research areas include: value of pharmacist services, affordability and access to medications, older adult medicine research and policy, high- risk medications and opioid use disorder. He was recently named the first pharmacist to the National Academy of Medicine (former Institute of Medicine) Emerging Leaders in Health and Medicine Scholars Program, Jonathan continues his national-level leadership in pharmaceutical research. THE CLASS OF 2019 WITH CHOICE GRADUATE PROGRAM MANAGER, MARINA GANO. JEAN AND HER FAMILY JOINED US FOR OUR ISPOR RECEPTION IN NEW ORLEANS! 42 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Alumni collaboration: In May 2019, CHOICE Director Anirban Basu and alumni Carrie Bennette, ’15, and Blythe Adamson, ’18, Anirban, Carrie led a workshop together called “Generating External Control Arms Using Real-World Data: Analytic Challenges and Recommendations” at ISPOR International Meeting in New Orleans. Carrie and Blythe also co-instructed the ISPOR Short Course “Tools for Reproducible Real-World Data Analysis” at the ISPOR International Annual Meeting, New Orleans, 19 May 2019, and ISPOR Europe, Barcelona, 10 Nov 2018. They will teach this again at the ISPOR Europe meeting this fall in Copenhagen. Some of the content from their course was highlighted in the Value and Outcomes Spotlight magazine. Adamson B, Kraut J, Bennette C. A Health Economist Walks Into a Tech Company: Principles for Reproducible Real-World Analyses. DR. WATANABE AND DEAN SEAN SULLIVAN PICTURED, AFTER Value & Outcomes Spotlight. May/Jun 2019;5(2):25-26. THE DON B. KATTERMAN MEMORIAL LECTURE WHERE HE WAS PRESENTED WITH THE DISTINGUISHED ALUMNI AWARD. In 2016, Jonathan was selected as the National Academy of Medicine (NAM) Anniversary Pharmacy Fellow. NAM fellows are chosen based on their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine (NASEM). Nationally recognized for his leadership and research, Jonathan’s research on cost of non-optimized medication regimens and policy recommendations on comprehensive medication management has been cited in successful legislation granting provider status for pharmacists. He collaborates with senior leadership of the Get The Medications CHOICE ALUMNI ENJOYING BEIGNETS AT CAFÉ DU MONDE IN NEW Right Institute to improve patient care via clinical pharmacists ORLEANS AFTER A DAY OF ISPOR CONFERENCE ACTIVITIES. nationally. In 2018, he was recognized as an NAM Emerging Leader in Health and Medicine. He serves the NASEM Forum on Drug Discovery and Translation: Examining the Impact of Real-World Evidence and was a contributor to the Making Medicines Affordable: A National Imperative report. Congratulations, Jonathan! UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 43


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    FACULTY GRANTS, AWARDS, AND ACTIVITIES Aasthaa Bansal Promoted to Associate Professor Invited presentation at Lifetime Data Science Conference, American Statistical Association, Pittsburgh, PA: “Evaluating the time-varying prediction accuracy of survival models used in dynamic decision-making” Invited presentation at Seattle Symposium in Health Care Data Analytics, Seattle, WA: “Biomarker Guided Dynamic Decision Making” Anirban Basu Distinguished Health Economics Author, Health Economics Journal. Served on, and completed, ISPOR Task FOrce on Value Lou Garrison of Information Analysis for Research Decisions. This task Served on ISPOR Health Policy Council and the ASCO Value Task force was formed to develop good practice guidance for Force Methodology Working Group. using methods of value of information analysis to inform Noteworthy talks given: both technology reimbursement decisions and research prioritization decisions. • “Novel Approaches to Value Assessment Within the Cost- Effectiveness Framework: An Introduction ISPOR Value Noteworthy Presentations Summit” in Washington, D.C, Oct. 19, 2018 • Willard G. Manning Memorial Lecture, University of Chicago • How can we value novel medicines? A health economic • “Do Current Practices of Clinical Comparative Effectiveness perspective Research and Evidence-based Medicine Breed Disparities?” • “Delivering novel therapies in the 21st century” https://chess.uchicago.edu/events/will-manning- • The Royal Society and National Academy of Medicines memorial-lecture/ London UK, October 2018 Josh Carlson • Valuing Innovative Medicines: Cost-Effectiveness Analysis Grant: BEAT MS, 10/01/2018 – 02/31/2020, Role: PI, Funder: and Affordability Benaroya Research Foundation, National Institute of Allergy • Algerian Pharmaceutical Federation Third National Congress and Infectious Diseases (NIAID) in Algiers, Algeria, in November 2018 This past year Dr Carlson has been leading the CHOICE • Received the PhRMA Foundation and Personalized Medicine Institutes ICER related work, continuing work on performance- Coalition 2018 Value Assessment Challenge First-Prize Award as based risk sharing arrangements, and expanding into lead author on a paper on “A Strategy to Support the Efficient cost-effectiveness alongside clinical trials with work on trial Development and Use of Innovations in Personalized and evaluating stem cell transplant versus best available therapy in Precision Medicine.” multiple sclerosis. • Received PhRMA Foundation Research Award for “Implementing Augmented Cost-Effectiveness Analysis: Challenges and Next Steps ($100,000). In collaboration with Office of Health Economics, London. • PI of the Pfizer-Sponsored Post-Doctoral Fellowship, 2018-2020 • Served on ISPOR Health Policy Council and the ASCO Value Task Force Methodology Working Group. 44 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    Ryan Hansen Activities 2019 Certificate of Merit in Precepting – • American Pharmacists Association Recognition for service University of Washington School of Pharmacy as Editor-in-Chief, Journal of the American Pharmacists Association, 2013-2019. 2019 Outstanding Contribution in Reviewing – • Member, Committee to Review Long-Term Effects of Journal of the American Pharmacists Association Antimalarial Drugs, National Academy of Medicine. 2018 National Adult and Influenza Immunization Summit (NAIIS) “Immunization Neighborhood” Adult Immunization Champion Dave Veenstra Award – Project VACCINATE Dr. Veenstra is collaborating with investigators at Vanderbilt University and Geisinger to study the cost effectiveness of Scott Ramsey population-level genomic screening. Greg Guzauskas, PhD Named Co-Chair of the Cancer Care Delivery Research Steering (CHOICE Senior Scientist) and Scott Spencer, MPH (PhD student Committee National Cancer Institute in Public Health Genomics) are developing the economic models for this ambitious project. Sean Sullivan Awarded the 2019 Icon of Pharmacy award, Davene Wright Oregon State University Awarded the Harvard Medical School Diversity Inclusion and Community Partnership Faculty Fellowship Andy Stergachis In September 2019, Dr. Wright will be joining the Department of Awards: Population Medicine at Harvard Medical School • Wall of Recognition, Stadium High School Shelly Gray Grants: Received the grant award, Reducing CNS-active Medications to • Medicines, Technologies, and Pharmaceutical Services Prevent Falls and Injuries in Older Adults (Phelan, Gray co-PIs). (MTaPS) CDC, 9/30/18-8/31/22 (15%), $2,900,000. • USAID. PI of UW Subcontract from MSH. 10/01/2018- Editors’ Choice Award for 2018, Journal of the American 09/30/2022 Geriatrics Society for Gray SL, Walker RL, Dublin S, Yu O, Bowles • Project overview: The goal of MTaPS is to enable EJ, Anderson ML, Crane PK, Larson EB. Proton pump inhibitor low- and middle-income countries to strengthen their use and dementia risk. J Am Geriatr Soc. 2018 Feb;66(2):247- pharmaceutical systems to ensure sustainable access to 253 doi: 10.1111/jgs.15073. and appropriate use of safe, effective, quality-assured, and affordable essential medicines and medicine-related Beth Devine pharmaceutical services. Grants • Landscape Analysis: Sentinel Site Readiness for Maternal Principal Investigator, Customizing Value-based Methods to Immunization Active Safety Surveillance in LMIC. Prioritize Implementation of Pharmacogenomic Clinical Decision • Bill & Melinda Gates Foundation. PI of UW Subcontract Support for Learning Health Systems, AHRQ 1R21HS026544-01 from Tulane. 6/1/2019-5/31/2021 (2019-2021) • Project overview: We will define the landscape for Principal Investigator, Evaluating the Impact of Pharmacogenetic integrated maternal immunization active safety Testing on Clinical Outcomes in a Retirement Community: A surveillance by reviewing the literature, building consensus Feasibility Study. UW School of Pharmacy Innovations Award among experts, and identifying potential sentinel sites in (2018-2019) low- and middle-income countries. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 45


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    FACULTY GRANTS, AWARDS, AND ACTIVITIES continued Consortium Site Principal Investigator (Assistant Director), Scott Ramsey Pacific Northwest Evidence-based Practice Center (EPC) V named Co-Chair of the Cancer Care Delivery Research Steering with Oregon Health & Science University (OHSU), AHRQ ( Committee National Cancer Institute 2015-present) Lead co-investigator, (PI: Goddard; Site PI G. Jarvik). Cancer CHOICE FACULTY IN THE NEWS Health Assessments Reaching Many (CHARM). Estimating Shelly Gray’s dementia research was mentioned in USA Today, the cost of using exome sequencing to diagnose individuals with KOMO News, and the June 2019 New York Times article, Risk hereditary cancer syndromes. NHGRI (2019-2021) for Dementia May Increase With Long-Term Use of Certain Lead Co-investigator (PI: Czerniecki). Improving Dysvascular Medicines: https://nyti.ms/2FBC5Cy Amputee Outcomes by Enhancing Shared Decision Making: Scott Ramsey was interviewed in an LA Times Article, Soaring an MCDA. Veterans Affairs Health Services Research and insurance deductibles and high drug prices hit sick Americans Development Service (2018-2022) with a ‘double whammy’, published June 2019: https://lat. Noteworthy Presentations ms/2MuYRSF “Pharmacogenetic testing: The economics of personalized Listen to Dr. Lou Garrison discuss the benefits and pitfalls of medicine”. Day of Science Keynote Address, American the QALY at ISPOR 2019. Pharmacists Association Annual Meeting and Exposition, Seattle, WA Video Interview (7:00): http://bit.ly/LOU-QALY Podcast: http://bit.ly/qaly-podcast “Using a Bayesian network meta-analysis to parameterize a cost-utility and value of information analysis of biologics for Moderate-to-Severe Crohn’s disease”. Society for Research Synthesis Methodology, Chicago, IL (with Mark Bounthavong) “From Evidence Synthesis to National Guidelines and Policy”. Center for Health Innovation & Policy Science (CHIPS) Seminar Series, University of Washington “Using online real world evidence tools to enhance formulary decision-making. Academy of Managed Care Pharmacy Nexus Meeting, Orlando, FL (with Jennifer Graff, Sophia Yun, Shuxian Chen and Jamie Ta). This presentation has been selected for inclusion in an AMCP online training program on Real World Evidence Awards Nominated for Faculty Mentor of the Year Award, UW School of Pharmacy (June) Activities Hosted a Fulbright Scholar to study evidence synthesis/ network meta-analysis - Teerapon Dhippayom, PharmD, MS, PhD. Assistant Professor, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand Continuing member of the Academy Health Methods and Data Council 46 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL UNIVERSITY REPORTOF WASHINGTON SCHOOL OF PHARMACY 46


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    FACULTY PUBLICATIONS AASTHAA BANSAL Zimmermann M, Brouwer E, Tice JA, Seidner M, Loos AM, Liu S, Bansal A, Sullivan SD, Lin V, Purdum A, Navale L, Cheng P, Ramsey Chapman RH, Kumar V, Carlson JJ. Disease-Modifying Therapies for SD (2019). Estimating long-term survival for patients with relapsed Relapsing-Remitting and Primary Progressive Multiple Sclerosis: A or refractory aggressive Non-Hodgkin Lymphoma treated with Cost-Utility Analysis. CNS Drugs. 2018;32(12):1145-57. doi: 10.1007/ Anti-CD19 Chimeric Antigen Receptor T-cell therapy: A comparison s40263-018-0566-9. PubMed PMID: 30141001. of standard and mixture cure models. Medical Decision Making, 39(3): 294-298. BETH DEVINE Bansal A, Heagerty PJ (2019). A comparison of landmark methods Hart MR, Garrison LP, Doyle DL, Jarvik GP, Watkins J, Devine B. and time-dependent ROC methods to evaluate the time-varying Projected cost-effectiveness for two gene-drug pairs using a performance of prognostic markers for survival outcomes. Invited multi-gene panel for patients undergoing percutaneous coronary article, Diagnostic and Prognostic Research, 3: 14. intervention. (in press at Value Health; June 2019) Bansal A, Heagerty PJ (2018). A tutorial on evaluating time-dependent Thompson M, Hardy V, Suchsland MZ, Devine B, Kurth D, chou discrimination accuracy for censored survival outcomes. Medical R, Haines R, Jarvik JG, for the PROD Research Group. A secondary Decision Making, 38(8): 904-916. analysis to identify patient-centered outcomes in the American College of Radiology’s Appropriateness Criteria. (in press at the J Amer Coll Rad; May 2019) DOUG BARTHOLD Barthold D, Joyce G, Wharton W, Kehoe P, Zissimopoulos J, 2018. “The McDonagh MS, Dana T, Selph S, Devine EB, Cantor A, Bougatsos C, association of multiple anti-hypertensive medication classes with Blazina I, Grusing S, Fu R, Kopelovich SL, Monroe-DeVita M, Haupt Alzheimer’s disease incidence across sex, race, and ethnicity,” PLOS DW. Treatments for Schizophrenia in Adults: A Systematic Review. ONE, published online November 1, 2018. Comparative Effectiveness Review No. 198. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290- Drabo EF, Barthold D, Joyce G, Ferido P, Chui HC, Zissimopoulos J, 2015-00009-I.) AHRQ Publication No. 17(18)-EHC031-EF. Rockville, MD: 2019. “Longitudinal analysis of dementia diagnosis and specialty Agency for Healthcare Research and Quality; October 2017. care among racially diverse Medicare beneficiaries.” Alzheimer’s & Dementia. Forthcoming. LOU GARRISON Marcum ZA, Hohl SD, Gray SL, Barthold D, Crane PK, Larson EB, Garrison LP Jr, Babigumira J, Tournier C, Goertz HP, Lubinga SJ, Perez 2019. “Brain health and dementia prevention: a mixed-method EA. Cost-Effectiveness Analysis of Pertuzumab With Trastuzumab analysis.” American Journal of Health Behavior, 43(2), 300-310. and Chemotherapy Compared to Trastuzumab and Chemotherapy in the Adjuvant Treatment of HER2-Positive Breast Cancer in the United States. Value Health. 2019. ANIRBAN BASU Grieve R, O’Neill S, Basu A, Keele L, Rowan K, Harris S. Which Garrison LP, Jackson T, Paul D, Kenston M. Value-Based Pricing deteriorating ward patients benefit from ICU transfer? A patient for Emerging Gene Therapies: The Economic Case for a Higher centered approach to clinical evaluation. JAMA Network Open 2019; Cost-Effectiveness Threshold. J Manag Care Spec Pharm. 2019 2(2):e187704. Jul;25(7):793-799 Basu A, Veenstra DL, Carlson JJ, Wang W-J, Branch K, Probstfield J. Li M, Basu A, Bennette C, Veenstra D, Garrison LP Jr. How Does How can clinical researchers quantify the value of their proposed Option Value Affect the Potential Cost-Effectiveness of a Treatment? comparative research? American Heart Journal 2019; 209:116-125 The Case of Ipilimumab for Metastatic Melanoma. Value Health. 2019 Jul;22(7):777-784 Basu A, Sohn M-W, Bartle B, Chan KCG, Guihan M, Cooper JM, Huang EH. Development and validation of the real-world progression in diabetes (RAPIDS) model. Medical Decision Making 2019;39(2):137-151. SHELLY GRAY Hart LA, Marcum ZA, Gray SL, Walker R, Crane PK, Larson EB. The association between central nervous system-active medication JOSHUA CARLSON use and fall-related injury in community-dwelling older adults with Carlson JJ, Kim DD, Guzauskas GF, Bennette CS, Veenstra DL, Basu dementia. Pharmacotherapy 2019 Mar 12. doi: 10.1002/phar.2244. A, Hendrix N, Hershman DL, Baker L, Ramsey SD. Integrating value of research into NCI Clinical Trials Cooperative Group research review Gray SL, Marcum ZA, Schmader KE, Hanlon JT. Recent Literature and prioritization: A pilot study. Cancer Med. 2018. doi: 10.1002/ Update on Medication Risk in Older Adults, 2017. J Am Geriatr Soc cam4.1657. PubMed PMID: 30030904. 2018; 66:2254–2258. doi: 10.1111/jgs.15665 Schwartz JB, Schmader KE, Hanlon JT, Abernethy DR, Gray SL, et al. Pharmacotherapy in Older Zimmermann M, Lubinga SJ, Banken R, Rind D, Cramer G, Synnott Adults with Cardiovascular Disease: Report from an ACC, AGS, NIA PG, Chapman RH, Khan S, Carlson J. Cost Utility of Voretigene Workshop. J Am Geriatr Soc 2018 DOI: 10.1111/jgs.15634 Neparvovec for Biallelic RPE65-Mediated Inherited Retinal Disease. Value Health. 2019;22(2):161-7. doi: 10.1016/j.jval.2018.09.2841. PubMed PMID: 30711060. RYAN HANSEN Hansen RN, Shirtcliff RM, Ludwig S, Dysert J, Allen G, Milgrom P. Changes in Silver Diamine Fluoride Use and Dental Care Costs: A Longitudinal Study. Pediatric Dentistry 2019;41(1):35-39. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 47


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    Bacci JL, Hansen RN, Ree C, Reynolds MJ, Stergachis A, Odegard Li SJ, Vodicka E, Peterson A, Stergachis A. Translating medicines to PS. The effects of vaccination forecasts and value-based payment patients: a novel methodology for quantifying the Global Medical on adult immunizations by community pharmacists. Vaccine Supplies and Donations Program. PLOS One. Nov 2;13(11):e0206790. 2019;37(1):152-9. Sobanjo-ter Meulen A, Munoz FM, Kaslow DC, Klugman KP, Omer SB, Gold LS, Patrick DL, Hansen RN, Goss CH, Kessler L. Correspondence Vora P, Stergachis A. Maternal Interventions Vigilance Harmonization between Lung Function and Symptom Measures from the Cystic in Low- and Middle-Income Countries: Stakeholder Meeting Report; Fibrosis Respiratory Symptom Diary-Chronic Respiratory Infection Amsterdam, May 1-2, 2018. Vaccine. 2019 May 6;37(20):2643-2650. Symptom Score (CFRSD-CRISS). Journal of Cystic Fibrosis 2019. In Press. SEAN SULLIVAN Ramsey SD, Shankaran V, Sullivan SD. Basket Cases: How real-world TOM HAZLET testing for drugs approved based on basket trials might lead to Karwaki TE, Hazlet TK, Wilson Norton JL. Professional Ethics: Lessons false diagnoses, patient risks, and squandered resources. Journal of Learned in Developing and Testing a Methotrexate Case Study for Clinical Oncology 2019. Pharmacy Education. Accepted for publication, Cambridge Quarterly Of Healthcare Ethics: CQ: The International Journal Of Healthcare Drummond MF, Neuman PJ, Sullivan SD, Toumi M, Dabbous O, Ethics Committees. Fricke F-U, Tunis S. Analytic considerations and a reference case for economic evaluations of gene therapy replacement. Value in Health 2019. ZACHARY MARCUM Sullivan SD, Nicholls CJ, Gupta RA, Meron AA, Wu J, Westerbacka Marcum ZA, Walker R, Bobb JF, Sin MK, Gray SL, Bowen JD, McCormick J, Bosnyak Z, Frias JP, Bailey TS. Comparable Glycemic Control and W, McCurry SM, Crane PK, Larson EB. Serum cholesterol and incident Hypoglycemia in Adults with Type 2 Diabetes after Initiating Insulin Alzheimer’s disease: findings from the Adult Changes in Thought Glargine 300 units/mL or Insulin Degludec: DELIVER Naive D Real- Study. J Am Geriatr Soc 2018;66:2344-2352. World Study. Diabetes, Obesity and Metabolism 2019. Marcum ZA, Hohl SD, Gray SL, Barthold D, Crane PK, Larson EB. Patient perceptions of antihypertensive use as a dementia prevention DAVID VEENSTRA strategy: a mixed-method analysis of a web-based survey. J Alzheimers Dis 2019;68:523-529. Guzauskas GF, Basu A, Veenstra DL. Are there different evidence thresholds for genomic vs. clinical precision medicine? A VOI-based Marcum ZA, Huang HC, Romanelli RJ. Statin dosing instructions, framework applied to antiplatelet drug therapy. Value in Health, in medication adherence, and low-density lipoprotein cholesterol: a press, 2019. cohort study of incident statin users. J Gen Intern Med 2019 [in press] Henderson LM, Robinson RF, Ray L, Li T, Dillard DA, Schilling BD, Mosley M, Janssen PL, Fohner AE, Rettie AE, Thummel KE, Thornton SCOTT RAMSEY TA, Veenstra DL. VKORC1 and Novel CYP2C9 Variation Predict Jones SMW, Chennupati S, Nguyen T, Fedorenko C, Ramsey Warfarin Response in Alaska Native and American Indian People. Clin SD. Comorbidity is associated with higher risk of financial burden Transl Sci. 2019 Mar 1. PMID: 30821933. in Medicare beneficiaries with cancer but not heart disease or Hendrix N, Ollendorf DA, Chapman RH, Loos A, Liu S, Kumar V, diabetes. Medicine (Baltimore). 2019 Jan;98(1):e14004. doi: 10.1097/ Linder JA, Pearson SD, Veenstra DL. Cost-Effectiveness of Targeted MD.0000000000014004. PubMed PMID: 30608446; PubMed Central Pharmacotherapy for Moderate to Severe Plaque Psoriasis. J Manag PMCID: PMC6344147. Care Spec Pharm. 2018 Dec;24(12):1210-1217. PMID: 30479197. Ramsey SD, Shankaran V, Sullivan SD Basket Cases: How Real-World Testing for Drugs Approved Based on Basket Trials Might Lead to DAVENE WRIGHT False Diagnoses, Patient Risks, and Squandered Resources. J Clin Oncol. 2019 Jun 24:JCO1802320. doi: 10.1200/JCO.18.02320. [Epub Wright DR, Saelens BE, Fontes A, Lavelle TA. “Parent-Preferred ahead of print] Financial Incentives to Promote Engagement in Family-Based Childhood Obesity Treatment: A Discrete Choice Experiment.” Grewal, Simrun; Ramsey, Scott; Balu S; Carlson, Josh J. Cost-savings JAMA Network Open. 2019;2(3):e191490. doi:10.1001/ for biosimilars in the United States: a theoretical framework and jamanetworkopen.2019.1490. PMID: 30924902 budget impact case study application using filgrastim. Expert review of pharmacoeconomics & outcomes research. 2018;18(4):447-454. Yonekawa KE, Zhou C, Haaland WL, Wright DR. “Nephrotoxin-related acute kidney injury and predicting high risk medication combinations in the hospitalized child.” Journal of Hospital Medicine. J Hosp Med. ANDY STERGACHIS 2019 Apr;14:E1-E6. doi: 10.12788/jhm.3196. PMID: 30986180. Roth L. Bempong DK, Babigumira J, Banoo S, Cooke E, Jeffreys D, Flynn-O’Brien KT, Richards M, Wright DR, Rivara FP, Haaland W, Kasonde L, Leufkens HGM, Lim J, Lumpkin M, Mahlangu G, Peeling Escobar T, Thompson L, Delsman A, Goldin A, Oldham K. “Health R, Rees H, Ndomondo-Sigonda M, Stergachis A, Ward M, Nwokike J, outcomes and healthcare and societal cost of optimizing pediatric Expanding Global Access to Essential Medicines: Investment Priorities surgical care in the United States.” Journal of Pediatric Surgery. 2018 for Sustainably Strengthening Medical Product Regulatory Systems. November. doi: 10.1016/j.jpedsurg.2018.10.102. PMID: 30598246. Global Health. 2018 Nov 1;14(1):102. 48 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2019 ANNUAL REPORT


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    STUDENT PUBLICATIONS ELIZABETH BROUWER ENRIQUE SALDARRIAGA Brouwer E, Basu A & Yeung K. Adoption of Cost Effectiveness- Lescano A, Antiporta D, Luna A, Saldarriaga E, Santibañez C, Driven Value-Based Formularies in Private Health Insurance from Soto-Herrera P, et al. [Challenges and Priorities: Peruvian policy in 2010 to 2013. PharmacoEconomics (2019). https://doi.org/10.1007/ adolescents and youth]. Lima, PE: The United Nations System in Peru; s40273-019-00821-5 2018 Sep p. 82. Zimmermann M, Brouwer E, Tice JA, et al. Disease-Modifying Therapies for Relapsing–Remitting and Primary Progressive Multiple KANGHO SUH Sclerosis: A Cost-Utility Analysis. CNS Drugs (2018) 32: 1145. https:// Carlson JJ; Suh K; Orfanos P; Wong W. Cost Effectiveness of Alectinib doi.org/10.1007/s40263-018-0566-9 vs. Crizotinib in First-Line Anaplastic Lymphoma Kinase-Positive Advanced Non-Small-Cell Lung Cancer. Pharmacoeconomics. Di Giorgio L, Mvundura M, Tumusiime J, Namagembe A, Ba A, 2018;36(4):495-504. Belemsaga-Yugbare D, Morozoff C, Brouwer E, Ndour M, Kidwell Drake J. (Oct 2018). Costs of administering injectable contraceptives through health workers and self-injection: evidence from Burkina Faso, Uganda, and Senegal. Contraception, 98(5), 389-395. https:// doi.org/10.1016/j.contraception.2018.05.018. Mclaren ZM, Sharp A Brouwer E & Nanoo A. (2018). The Impact of Anti-Retroviral Therapy on Tuberculosis Detection at the National Level in South Africa. The American Journal of Tropical Medicine and Hygiene,99(6), 1407-1414. doi:10.4269/ajtmh.17-0530 SIMI GREWAL Grewal S, Ramsey S, Balu S, Carlson JJ. Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim. Expert review of pharmacoeconomics & outcomes research. 2018;18(4):447-454. NATHANIEL HENDRIX Debellut F, Hendrix N, Pitzer VE, Neuzil KM, Constenla D, Bar-Zeev N, Marfin A, Pecenka C. Forecasting demand for the typhoid conjugate vaccine in low-and middle-income countries. Clinical Infectious Diseases. 2019 Mar 7;68(Supplement_2):S154-60. Hendrix N, Ollendorf DA, Chapman RH, Loos A, Liu S, Kumar V, Linder JA, Pearson SD, Veenstra DL. Cost-Effectiveness of Targeted Pharmacotherapy for Moderate to Severe Plaque Psoriasis. Journal of managed care & specialty pharmacy. 2018 Dec;24(12):1210-7. Carlson JJ, Kim DD, Guzauskas GF, Bennette CS, Veenstra DL, Basu A, Hendrix N, Hershman DL, Baker L, Ramsey SD. Integrating value of research into NCI Clinical Trials Cooperative Group research review and prioritization: A pilot study. Cancer medicine. 2018 Sep;7(9):4251-60. BOSHEN JIAO Jiao B, Zafari Z, Ruggeri K, Williams SZ. Depressive Symptoms and Sexually Transmitted Disease: Evidence from a Low-Income Neighborhood of New York City. Community mental health journal. 2019 May 9:1-5. Xu Y, Parikh NS, Jiao B, Willey JZ, Boehme AK, Elkind MS. Decision Analysis Model for Prehospital Triage of Patients With Acute Stroke. Stroke. 2019 Apr;50(4):970-7. Li S, Jiao B, Zafari Z, Muennig P. Optimising the Cost-effectiveness of Speed Limit Enforcement Cameras. Injury Prevention. 2019 Aug 1;25(4):273-7. UNIVERSITY OF WASHINGTON SCHOOL OF PHARMACY 49


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    THANK YOU TO OUR DONORS Abbvie, Inc. Bristol-Myers Julie and David Veenstra PFIZER INC Allergan Foundation Squibb Company Lisa M. Meckley Seattle Genetics Amgen Inc. Curta Consulting Seattle Lisa Mandin Sean and Catrena Amy K. Becklund Emily Beth Devine Meghann Glavin Sullivan Anirban and Kranthi Genentech, Inc. Merck Takeda Pharmaceuticals Basu Glaxosmithkline U.S.A., Inc. Microsoft Corporation Avexis Inc. Mitchell and Mandy Higashi Tucker Sylvestro Nathorn Chaiyakunapruk Douglas G. Barthold Josh Carlson William B. Wong Novartis Institutes For Bayer Corporation Joshua A. Roth Biomedical Research, Inc. Zachary Marcum Benevity Julia F. Slejko Novo Nordisk Inc. 50 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2018 ANNUAL REPORT 50 THE COMPARATIVE HEALTH OUTCOMES, POLICY, AND ECONOMICS INSTITUTE 2018 2019 ANNUAL REPORT

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