USING LARGE DATABASES AND COMPUTERS
TO STUDY HEALTH PROBLEMS
and
July 12, 2010
University of Mississippi
School of Pharmacy
• 6 academic departments
Medicinal Chemistry, Pharmaceutics, Pharmacognosy, Pharmacology,
Pharmacy Administration, Pharmacy Practice
• 2 research centers in the Research Institute of Pharmaceutical
Sciences (RIPS)
National Center for Natural Products Research (NCNPR)
Center for Pharmaceutical Marketing and Management Research (CPMM)
Slide 2
CPMM/PHAD research project staffing
• RIPS/ CPMM personnel
•
•
2 Research faculty (PhD) – all have joint appointment in Pharmacy
Administration
2 Support staff
• Pharmacy Administration personnel
•
•
6 Faculty (PhD) – all have joint appointment in CPMM
14 MS and PhD graduate students (7 receive stipend support from RIPS and
CPMM)
• Close collaborative relationship with Medical Marketing and
Economics (MME) a local pharmaceutical marketing consulting
company (4 of 5 starting partners are PHD graduates of Pharmacy
Administration department)
Slide 3
We do research on a broad assortment
of topics?
We study everything related to:
• The selection and use of pharmaceutical products.
• Medication use patterns and trends in markets.
• How marketing affects product selection.
• How product selections are made and what influences the decisions of
the various players involved.
• How medication use and use behaviors (e.g., compliance) affect health
outcomes.
• The development and provision of pharmacy services.
•
•
•
•
•
Pharmacists job satisfaction.
What services are being delivered and by whom.
How to better deliver pharmacy services.
The economic viability of community pharmacies.
How pharmacy services affect health outcomes.
Slide 4
Research with administrative claims data is
becoming an increasingly important area
• FDA Sentinel program launched recently to identify and evaluate
potential safety problems with approved drugs.
• Medicare and PBMs evaluating cost/outcomes of plan designs in
order to determine the most cost-effective coverage.
• CMS-Medicare identifying effective medication use quality measures
for intervention through Quality Improvement Organizations.
• AHRQ and other organizations interest in comparative effectiveness
studies for treatment alternatives – medications within class and
medications across classes.
• Gradual movement toward true “evidence-based” medical decision
making.
Slide 5
CPMM -- building access for UM researchers
to administrative claims data
• Current data repositories:
• 2002 – 2004 MS Medicaid data for all beneficiaries – installed and
operational.
• 2006 – 2007 Medicare data for 5% national sample of beneficiaries –
installed and operations.
• Other data being obtained this year (target date of Octorber):
• 2005 – 2007 MS Medicaid data for all beneficiaries.
• 2004 – 2007 Medicare data for MS residents
• 2008 Medicare data for 5% national sample of beneficiaries.
Slide 6
Major technology challenges with
pharmacoepidemiology research
• Data management of large multiple linked files
• Typical health administrative claims data files
• Beneficiary information
• Prescription drug claims
• Institutional short-stay inpatient claims
• Institutional outpatient claims
• Medical care claims
• Long-term care claims
• Any number of claims of each type for each beneficiary
• Millions of beneficiaries
• HIPAA and the Privacy Rule
• “Research identifiable data” standards
Slide 7
CPMM procedure for research repositories
containing personal health information (PHI)
Identified PHI data
obtained on CD / DVD
Data accessed and
analyses run on
restricted network
server.
Identifier fields encrypted
and modified as needed to
create limited data set files.
Stand-alone Secure Computer
(maintained by CPMM)
Data moved to
restricted network
using external
physical device.
Restricted Network
Computer
(maintained by CPMM)
Original disks
stored in safe
Only output files
can be
downloaded for
report
development.
Authorized
Researchers
When DUA expires, disks are
returned or destroyed – files on
research network deleted.
Slide 8
Examples of Recent
and Current Projects
Pharmacoepidemiology projects funded
during last two years
• Intervention and Support Work Using Integrated Medicare Data
(funded by CMS – IQH)
• Examined hospitalization, ED visits and death related to proposed
medication use quality measure for the Medicare program.
• Examination of Medication Use Quality Measures in Mississippi
Medicaid Population (funded by CMS-ORDI).
•
Examined hospitalization, ED visits and death related to proposed
medication use quality measure for the Medicare program.
• Using Medicare Claims Data to Evaluate Medication Utilization and
Safety in the Elderly Population (funded by HRSA-OHIT) currently underway
• Examining changes in medication use behaviors and health outcomes
related to patients entering the doughnut hole for Medicare Part D
coverage.
• Examining the use of Medicare claims data for assessing FDA safety
signals.
Slide 10
Pharmacoepidemiology projects funded
during last two years
• Using Medicare/Medicaid Claims Data to Support Medication
Outcomes and Pharmacovigilance Research (funded by CMS-ORDI)
currently underway
• Examining the application of national pharmacy quality measures
among Mississippi pharmacies using Medicaid and Medicare data.
• Examining the effect of the Mississippi Medicaid prescription cap on
medication use behaviors and outcomes.
• Evaluating the relationships among medication utilization and
adherence and health outcomes in elderly, post myocardial infarction
(MI) patients as secondary prevention following a myocardial infarction.
• Database Study to Evaluate the Impact of Multiple Sclerosis in a
Medicare Patient Population (funded by EMD Serono) contract currently being
finalized
• Will examine treatment patterns, adherence and outcomes among
Medicare beneficiaries with multiple sclerosis.
Slide 11
Podium presentation: 2009 International Society for Pharmacoeconomics and
Outcomes Research, Orlando, FL.
Presenters: Yi Yang, Vennela Thumula, Pat Pace, Ben Banahan, Noel Wilkin, Bill
Lobb
Slide 12
Poster presentation: 2009 International Society for Pharmacoeconomics and
Outcomes Research, Orlando, FL.
Presenters: Krutika Jariwala, Ben Banahan, Yi Yang, Pat Pace
Slide 13
Poster presentation: 2009 International Society for Pharmacoeconomics and
Outcomes Research, Orlando, FL.
Presenters: Yi Yang, Vennela Thumula, Pat Pace, Ben Banahan, Noel Wilkin, Bill
Lobb
Slide 14
Poster presentation: 2010 American Pharmacists Association Annual Meeting,
Washington, DC.
Presenters: Matt Hill, Yi Yang, Vennela Thumula, Pat Pace, Ben Banahan, Noel
Wilkin
Slide 15
Poster presentation: 2010 International Society for Pharmacoeconomics and
Outcomes Research, Atlanta, GA.
Presenters: Ben Banahan, Clive Mendonca, Amod Athavale, John Bentley
Slide 16
Poster presentation: 2010 International Society for Pharmacoeconomics and
Outcomes Research, Atlanta, GA.
Presenters: Ben Banahan, Pat Pace
Slide 17
Questions
and
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