GHECon affiliate profile Leslie Wilson … 4- July-13
Name
Affiliations
Narrative
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detailed
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projects and
publications
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projects
Leslie W. Wilson, PhD
Department of Medicine (Urology, Osher Center) and Department of Clinical Pharmacy
Dr. Wilson’s interests include a long-standing research and teaching commitment to
health services research and the comparative effectiveness and economic analysis of
disease and its treatments. My primary research interest is to understand how new
treatments or types and patterns of care change the costs and outcomes of care. The
cost and cost-effectiveness analyses I have carried out are focused mainly on cancer,
AIDS, genetic testing, multiple sclerosis, alzheimers, and global health and diseases
(chagas and valley fever); although I have also looked at both rare and highly prevalent
chronic diseases. I also look at economic effects of policy questions, primarily for
California Workers Compensation, and Boys and Girls Clubs. My research on outcomes
of care has focused on patient decision making, especially when weighing the risks and
benefits of treatments, using measures of conjoint analysis, willingness to pay, and
standard gamble. My teaching has focused on health economics, pharmaco-economics,
policy analysis, and decision analysis.
 Examine economic effects of global health disease and their treatments (Chagas and
Valley Fever)
 Foster UCSF global health economics capacity (via GHECon)
 Affect health policy through economics research
 Foster health economics knowledge for students and faculty within UCSF
 Act as a liaison between academia and pharmaceutical industry for research and for
connecting students with employment opportunities
1). Comparative Effectiveness Analyses:
a. Although these studies encompass both rare diseases and common chronic diseases,
my major focus has been on neoplastic diseases. For example I continue to work with
the department of urology and their CaPSURE longitudinal data base to examine the
economic issues of prostate cancer. I have one published paper on prostate cancer
costs and one just submitted. For the past 3 years I have been working on 2 NIH
Challenge Grants in Comparative Effectiveness Research (CER); the first to examine the
cost effectiveness (CE) of prostate cancer treatments, and the second to examine the CE
of robotic vs open prostatectomy. The PIs on both grants are urology surgeons Martin
Sanda (Harvard) and Peter Carroll (UCSF).
b. I am also comparing costs of care in hospitalized patients with and without dementia
We are using a de-identified Kaiser Permanente data base on all dementia patients in
Northern California and compared the differences in hospital use and costs among
patients with and without dementia, controlling for co-morbidities. We have found that
there is a difference of almost 1 day despite our matched sample, but that comorbidities and dementia account for the most differences.
2). Cost-effectiveness Analysis: I also worked with the VA to conduct a cost
effectiveness study comparing new treatments for metastatic, castrate resistant
prostate cancer. We compared three drugs and a placebo to determine that
abiraterone is the most cost-effective treatment. We are also conducted a follow-up
study comparing an additional new drug (enzalutimide), modifying our decision model.
3). My third major area of research is in international health. I have completed the
research from the 2 grants from UC-MEXUS to examine various epidemiological and
economic issues for the parasitic disease Chagas which is prevalent in Latin America and
have published these. I received a new grant from Pacific Rim to examine health effects
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of economic crises in countries of the Pacific Rim. We have completed the first part of
this study, demonstrating the effect of a generic drug policy (2002), begun right after
Argentina’s economic crisis (2001), to improve access to medications. We showed with
an interrupted time series design, that the policy did decrease drug prices, with a
differential effect for brand vs generic drugs.
I have been the co-director of the subcommittee on education for COEMH (migration
health) with the Global Health Sciences Institute at UCSF. This group involves all 10 UC
campuses. We are just starting a grant proposal to look at the immunology and
economic effects of valley fever (coccidioidomycosis) on severity of disease in the HIV
and migrant population.
4). I also have been working heavily in the economics of patient decision aids. I have a
publication looking at the WTP for decision aid use in community breast cancer
patients. I am a co-PI with a subcontract from Harvard with Donna Berry, to determine
the cost-benefit of a computerized treatment decision aid for patients with primary
prostate cancer. I am developing the economic and WTP utility measures for this study
now. I am a co-investigator on two NIH grants to examine the cost implications of
decision aids in the HIV population. The first (with Jacqueline Tulsky, UCSF) is to
examine the cost benefit of using IT to deliver system change to outpatient treatments
for chronic HIV/AIDs patients. I have developed the measures for collection of health
care utilization which is now ongoing. The second is with (Adam Carrico, UCSF)
comparing the cost benefit of two education/support programs to increase medication
adherence in patients with HIV/AIDS who are also drug abusers. I am developing the
measures to include in the patients interviews for data collection now and then will
conduct the analyses for both these studies. I am also a faculty member of the Osher
Center for Integrative Medicine in the Department of Medicine at UCSF and am
responsible for consulting on economic and health services research studies at the
center.
Collaborators
(selected)
5 key
publications
5). I also have made individual decision making when weighing risks and benefits of
treatment a major focus of my last 3 years of research. I received a grant from Novartis
to compare patients preferences for the attributes of hypothetical DMT medications
for relapsing remitting multiple sclerosis. We did a prospective study in 350 RRMS
patients. We used a choice based conjoint analysis and standard gamble analysis to
determine patients preferences for hypothetical drug attributes across a wide range of
levels when weighing risks and benefits of treatment. We found patients did weigh
risks and benefits which varied by their disease severity.
 Statisticians: C. McCulluch, UCSF; A. Corrico, E. Vittinghoff at UCSF
 Clinical & epidemiology researchers: P. Carroll, E Wabbant, Bruce Cree, D Goodin,
and others at UCSF; M. Sanda & Donna Berry at Harvard; B. Custer at Blood Systems
America; P. Brown, D Ojcius at UCMerced; J Goldhaber-Fiebert, Stanford.
 Program implementers: J. Schauer, CA workers comp;
 International Collaborators: J. Ramsey, Mexico; U. Garay, Argentina
1. Wilson LS, Zong L, Basu, R, Comparative effectiveness research: Erectile
dysfunction longitudinal HRQOL outcomes and costs within and across
treatments for primary prostate cancer. Urology. Submitted March, 2013.
2. Wilson LS, Loucks A, Gipson G, Zhong Lixian, Bui C, Miller E, Owen M, Pelletier
D, Goodin D, Waubant E, McCulloch C. Patient preferences for attributes of
disease modifying multiple sclerosis therapies: Development and results of a
ratings based conjoint analysis. MS Journal. Submitted April, 2013.
3. Wilson L, Stupar L, O’Donnell S, Loucks A, Moor D, Jupiter C, Johnson N, Belkora
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Teaching
Skills
Substantive
areas
J, Cost benefit analysis of decision support methods for patients with breast
cancer in a rural community: a randomized trial. Community Oncology. 2013. In
press. http://rapidproof.cadmus.com/RapidProof/retrieval/index.jsp
4. Wilson L, Zhong L, Pon V, Srinivas S, Nguyen N, Frear M, Kwon S, Gong C,
Malmstrom R. Therapeutic Options in Metastatic Castration-Resistant Prostate
Cancer: A Cost-Effectiveness Analysis. PLOS ONE: Accepted March, 2013.
5. Belkora J, Stupar L, O’Donnell S, Loucks A, Moor D, Jupiter C, Johnson N, Wilson
L; Decision support by telephone: Randomized controlled trial in a rural
community setting. Patient Educ Couns. 2012 Oct;89(1): 134-42. PMID:
22776761
6. Wilson LS, Hensic L, Paoli CJ, Basu R, Christenson M, Moskowitz JT, Wara D. The
effect of prophylaxis on pediatric HIV costs. 2012;24(1):108-18. Epub 2011 Jul
25. PMID: 21780991
7. Wilson LS, Pregenzer M, Basu R, Bertenthal D, Torres J, Asgari M, Chren MM.
Fee comparisons of treatments for Non Melanoma Skin Cancer in a private
practice academic setting .Dermatol Surg. 2011 Dec 6. Doi: 10.1111/j.15244725. 02231.x (Epub ahead of print). PMID: 22145798
8. Wilson LS, Gitlin M, Lightwood J. Schizophrenia costs for newly diagnosed
versus previously diagnosed patients. American Journal of Pharmacy Benefits.
2011; 3(2): 107-115.
My teaching responsibilities are primarily for the CP158 Decision Analysis Class which I
co-ordinate and teach in Department of Clinical Pharmacy.
Established: Economic Modeling; Multivariate Data Analysis, Cost effectiveness analysis,
Conjoint Analysis, WTP and Standard Gamble Measurement, Survey design
.
Established: Comparative Effectiveness, Cost effectiveness, WTP, Conjoint Analysis,
Policy analysis, economics in workers compensation programs, cost benefit analysis,
program evaluation. Quality of life measurement; economic measure in drug clinical
trials. Consultant for drug industry.
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