Pharmacy News Archives - School of Pharmacy

SOP Has Strong Showing at Northwest Pharmacy Convention

The UW School of Pharmacy had a strong presence at the recent Northwest Pharmacy Convention in Coeur d’Alene, ID, with 8 students, 7 faculty, and many alumni in attendance.

Highlights:

Dakota Fletcher (Class of 2027) completed his two-year term serving on the WSPA Board of Directors.

Our recent graduate, Amanda Bryan (Class of 2025), won the resident poster presentation competition for her project, “Optimizing Patient Care Service Implementation and Engagement in Independent Pharmacies Through a Resident-Led Coaching Model.” Her co-investigators included Jennifer Bacci and clinical faculty Matt Binder and Sirena Kalinski.

UW faculty also contributed several CE presentations:

“Changing Course: Rethinking Diabetes Management and Aging”
Speakers: Abby Winter, PharmD, MPA, CDCES & Amanda Bryan, PharmD

“Community Pharmacy Networking Session: Travel Health on the Move”
Speaker: Lisa Garza, PharmD

“Precepting with Purpose: Turning Everyday Teaching Into CPD Credit”
Speakers: Jennifer Adams, PharmD, EdD, FAPhA, FNAP; Taylor Bertsch, PharmD; Cherith Smith, PharmD; Rachel Allen, PharmD

“Evidence Based Discussion of Fever Management During Pregnancy”
Speaker: Mary F. Hebert, PharmD, FCCP

Dr. Kyu Lee Awarded NIH/NIAID K01 Career Development Award

Dr. Kyu Lee, PhD, Assistant Professor of Health Decision Science, The CHOICE Institute

University of Washington Assistant Professor of Health Decision Science, Dr. Kyu Lee, PhD, has been awarded a 5-year K01 career development award from the National Institute of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) for research on the role of vaccine antigenic match in improving the effectiveness of seasonal influenza vaccines and the value of expanding genomic surveillance to inform vaccine strain selection.

The NIAID K01 provides a structured framework for Lee to accelerate the development of an independent, interdisciplinary research program. Through targeted mentorship and collaboration with experts in health economics, infectious diseases, viral evolution, and biostatistics, the award supports the expansion of her research portfolio in influenza and other evolving pathogens.

Lee, a faculty member in the UW Department of Pharmacy and The CHOICE Institute, sees the award as a pivotal step in establishing an independent research program at the intersection of decision science, vaccinology, and pathogen evolution.

“The K01 award represents an important milestone in my transition to independence as a researcher,” she said. “It provides a unique opportunity to build on my expertise in decision science and simulation-based policy evaluation while expanding into new areas such as vaccinology and pathogen evolution. This interdisciplinary training will allow me to integrate methods across fields to advance influenza policy research.”

Her work addresses a gap that has long complicated influenza vaccine research: isolating the contribution of antigenic match — how well a vaccine strain resembles the viruses actually circulating in a given season — from the many other factors that shape vaccine effectiveness. Using quantitative approaches including geospatial analysis and value-of-information analysis, Lee aims to generate evidence that supports more efficient resource allocation and decision-making for seasonal influenza vaccination programs.

Lee’s path to influenza research was shaped in part by the COVID-19 pandemic, which drew her attention to the unique challenges posed by continuously evolving respiratory viruses.

“Influenza has a long history of vaccine development, yet continuous viral evolution poses persistent challenges to vaccine effectiveness,” she noted. “The potential for pandemics driven by major antigenic shifts underscores the importance of rapidly translating surveillance data into policy decisions. This intersection of uncertainty, data, and decision-making makes influenza policy an especially compelling area for applying decision science methods.”

The award will support close collaboration with an outstanding team of mentors, including Dr. Anirban Basu, Stergachis Family Endowed Director and Professor of Health Economics at The CHOICE Institute; Dr. Janet Englund, Professor of Pediatric Infectious Diseases at Seattle Children’s Hospital; Dr. Trevor Bedford, Professor in the Vaccine and Infectious Disease Division at Fred Hutch and a leading expert in viral evolution and genomic surveillance; and Dr. Adam Szpiro, Professor of Biostatistics at the University of Washington. Together, their expertise will be instrumental in shaping Lee’s long-term research trajectory.

Please join us in congratulating Dr. Lee on this well-deserved recognition. We look forward to seeing the impact her work will have on influenza vaccine policy and public health for years to come.

New Study Offers First Drug-Level Analysis of Medicare Savings from IRA Price Negotiation, Accounting for Market Dynamics

CHOICE PhD candidate Yunjoo Karris Jeon leads research providing a more nuanced picture of what federal drug price negotiation is projected to save.

A new study published in Value in Health offers the first drug-level analysis of projected Medicare savings from the Inflation Reduction Act’s drug price negotiation program to incorporate drug-specific utilization and price trajectories — and projects lower savings than prior estimates.

Led by CHOICE PhD candidate Yunjoo Karris Jeon, MSc, the study represents the first aim of her dissertation, projecting savings at the individual drug level for the ten Medicare Part D drugs selected for the inaugural round of negotiation, with prices taking effect in 2026. This drug-level approach reveals which drugs drive greater savings and why.

Key Findings

The research projects $2.3 billion in 2026 savings — an 8.8% reduction — compared to a historical benchmark scenario without negotiation. That figure is notably lower than prior estimates from the Congressional Budget Office (CBO, $3.7 billion) and the Centers for Medicare & Medicaid Services (CMS, $6.0 billion) — a difference the study attributes to three factors neither the CBO nor CMS accounted for: how drug use and prices naturally change over time, the anticipated entry of generic and biosimilar alternatives for five of the ten drugs, and a redesign of Medicare’s manufacturer discount structure, which affects how net prices are calculated. When generic and biosimilar competition alone was removed, projected savings rose to $4.7 billion, more in line with CBO and CMS figures. Savings projections should account for anticipated generic and biosimilar competition, which can substantially reduce negotiation’s impact.

The drug-level results showed that negotiation appears most effective for drugs with low prior rebates and long periods of market exclusivity — products that have not benefited from existing rebate systems and that have maintained sustained market dominance.

The team also went beyond a simple before-and-after comparison, evaluating negotiated prices against a counterfactual in which the selected drugs were not negotiated but instead subject to the new Manufacturer Discount Program. Under that comparison, negotiation was projected to save $2.4 billion (9.0%).

Implications for Policy

As the negotiation program expands to additional drugs, these results underscore that projected savings will vary widely.

“Medicare drug price negotiation is not a one-size-fits-all mechanism. How much it saves depends on the rebates and competitive history of each drug selected — a consideration that will grow more important as subsequent rounds proceed,” Jeon says.

The study was co-authored with CHOICE faculty Professor Sean D. Sullivan, BScPharm, MSc, PhD, and Professor Ryan Hansen, PharmD, PhD, alongside Kristi Martin, MPA, Director (Health Care) at Camber Collective and Nico Gabriel, MA, Health Insurance Specialist at the Centers for Medicare & Medicaid Services.

The full paper is available in Value in Health (DOI: 10.1016/j.jval.2026.03.010). Link: https://www.sciencedirect.com/science/article/pii/S1098301526001129?dgcid=author

UW School of Pharmacy’s Sean Sullivan receives ISPOR lifetime achievement award

Honor recognizes decades of leadership in health economics and outcomes research through scholarship, policy impact and mentorship.

Sean D. Sullivan, Professor and former Dean in the University of Washington (UW) School of Pharmacy, and longtime leader of the Comparative Health Outcomes, Policy, and Economics Institute, or CHOICE Institute, has received the Avedis Donabedian Lifetime Achievement Award from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), the Professional Society for Health Economics and Outcomes Research. The award recognizes a career of sustained contribution to the science and practice of improving healthcare quality, value and decision-making.

Over more than three decades, Sullivan has helped shape the field of health economics and outcomes research through scholarship, policy leadership, teaching and mentorship. He also serves on the ISPOR Board of Directors as its current Treasurer and has previously served as President of the Society. Colleagues who nominated him for the award described his career as one defined by “scientific excellence, methodological rigor, and health policy,” and credited him with helping build CHOICE into one of the world’s leading academic centers in the field.

His work has had a lasting effect on how evidence is developed and used by payers, policymakers and clinicians, and Sullivan has played a pivotal role in advancing the Academy of Managed Care Pharmacy Format, budget impact analysis methods and value-based formulary design — contributions that helped change how clinical and economic evidence are presented and applied in coverage and reimbursement decisions in the United States.

Sullivan’s scholarship is both broad and influential. He has authored more than 440 peer-reviewed publications across a wide range of health conditions, with research that has informed clinical guidelines, payer and government policies, and health technology assessment processes. Most recently, his work has helped bring clarity to the complex and evolving policy landscape surrounding Medicare drug price negotiation under the Inflation Reduction Act.

Just as significant is the reach of his mentorship. Over the course of his career, Sullivan has mentored more than 90 trainees and faculty members, many of whom now serve in leadership roles across academia, state and federal governments, industry and payer organizations. That legacy has extended his influence far beyond his own scholarship.

Those who have worked alongside Sullivan point not only to the significance of his scholarship, but to the community of inquiry and mentorship he helped build around it.

“Simply put, I came to UW to work with and be trained by Sean Sullivan,” said Jonathan H. Watanabe, Professor and Goyan Presidential Chair, Department of Clinical Pharmacy, University of California, San Francisco School of Pharmacy. “The environment he has cultivated, the innovations he has fostered, the friendships he has nurtured that have all nucleated from the steadfast notion of applying scientific thinking and principles to better understand, quantify, and promote health in the real-world is unique on earth.”

Shelby Reed, Professor in Population Health Sciences and Medicine, Duke University, emphasized both the quality and relevance of Sullivan’s work, as well as the example he has set for others in the field.

“Sean’s massive body of research exemplifies best practice in addressing questions that matter,” Reed said. “His recent work investigating the impact of changes in drug pricing in the U.S. sheds light on the thorny intersection of affordability, innovation, and improving health outcomes for patients.” She added, “Sean’s impact on health economics and outcomes research is exponentiated through his steadfast commitment to lifelong mentoring to so many people in the field. I am lucky to be one of them.”

Andy Stergachis, Professor of Pharmacy and Global Health at the UW School of Pharmacy, said Sullivan’s career has left a lasting mark on both the profession and the many people shaped by his work.

“Having known Sean since his graduate school days, I have had the privilege of witnessing the truly remarkable trajectory of his academic and professional career and its impact,” Stergachis said. “His achievements have yielded lasting benefits for generations of his mentees, the profession of pharmacy, the healthcare system, and society at large. This lifetime achievement honor is a fitting recognition of his pioneering and enduring leadership and many contributions to the economic evaluation of health care technologies and practices, as well as to pharmaceutical and medical technology pricing and policy.”

Scott Ramsey, Director of the Hutchinson Institute for Cancer Outcomes Research at Fred Hutch Cancer Center, Professor of Medicine, and Adjunct Professor of Pharmacy, underscored the breadth of Sullivan’s influence as a scholar, teacher and mentor.

“Through his leadership, mentorship of generations of students, and scholarship, Sean has elevated the School of Pharmacy, launched dozens of successful careers, and built a legacy of research and teaching that is without peer,” Ramsey said. “He is a true giant in the field, and an incredibly positive force for the profession.”

Ryan Hansen, Professor and Chair at the UW Department of Pharmacy was first introduced to the field of Health Economics and Outcomes Research by Sullivan, and was mentored by him through graduate school. Hansen said: “Sean has had a lasting impact on so many lives around the globe, from patients to clinicians, and of course scientists in the field of HEOR. The Donabedian Award is a wonderful testament to his many scientific achievements and ongoing career.”

The field has evolved over the course of Sullivan’s career. When he entered health economics and outcomes research, the discipline was still establishing itself. Over time, the questions it raised — about value, affordability and evidence — moved from the margins to the center of healthcare decision-making.

Still, the central responsibility of the field has not changed: to produce rigorous evidence, communicate it clearly and ensure that it is used appropriately.

“It isn’t about data or methods,” Sullivan said. “It’s about patients who need medicines they can afford, and policymakers who need evidence they can trust.”

Sullivan’s career has also been recognized through his election to the National Academy of Medicine, designation as a Fellow of the American Association for the Advancement of Science, and the Academy of Managed Care Pharmacy Foundation Steven G. Avey Award for sustained and distinguished service to managed care pharmacy.

Along with the Donabedian Award, these honors reflect a career devoted not only to advancing a field, but to strengthening the connection between evidence and better healthcare decisions.

About the UW School of Pharmacy
The University of Washington School of Pharmacy advances better health through innovative research, education and service, and prepares the next generation of scientists, pharmacists and health care leaders.

Welcoming our 2026-2028 Cohort of HEOR Fellows

The CHOICE Institute is pleased to announce the 2026-2028 cohort of HEOR Fellows who will start their programs on July 1, 2026. Our HEOR fellows work closely with faculty in the CHOICE Institute on projects where they learn first-hand how to apply the principles of outcomes research to real-life problems. These fellowships provide students with a year of study at the University of Washington, usually combined with a period of applied research at the sponsoring company. The year of study leads to an MS degree in Health Economics & Outcomes Research.

These training programs in health economics, outcomes research, and policy each combine the resources of a leading academic center for pharmaceutical economics and policy with the dynamic, real-world training of major pharmaceutical and biotechnology companies recognized for their commitment to innovation. Read more about our industry fellowship programs.

Meet the fellows:

AbbVie

Sharon Kim, University of California-Irvine

UW Mentor: Kyu Lee, PhD, Assistant Professor, Department of Pharmacy, The CHOICE Institute

Bayer

Quinn Lifschitz, University of Utah

UW Mentor: Ryan Hansen, PharmD, PhD, Professor & Chair, Department of Pharmacy, The CHOICE Institute

Duc Pham, University of Minnesota

UW Mentor: Ryan Hansen, PharmD, PhD, Professor & Chair, Department of Pharmacy, The CHOICE Institute

Genentech

Brianne Burns, Thomas Jefferson University

UW Mentor: Dave Veenstra, PharmD, PhD, Professor, Department of Pharmacy, The CHOICE Institute

Pfizer

Julia Song, University of Utah

UW Mentor: Josh Carlson, MPH, PhD, Professor, Department of Pharmacy, The CHOICE Institute

Sanofi

Kendall Derber, University of Utah

UW Mentor: Sean D. Sullivan, BScPharm, MSc, PhD, Professor, Department of Pharmacy, The CHOICE Institute

Growing Older in the Age of AI

Aging is one of the few experiences that is both deeply personal and entirely universal.

If we are fortunate, we grow older. We notice small changes first — a little more effort getting out of a chair, a second look at a medication label, a new awareness of balance or memory. Over time, aging reshapes routines. It invites new kinds of independence and, sometimes, new kinds of support.

Most of us will also find ourselves caring for someone older — a parent, a partner, a friend. We will learn how much daily life depends on small, steady acts: a reminder, a lift, a check-in call, a quiet reassurance.

And now, woven into that everyday reality, is artificial intelligence.

AI is already drafting emails and diagnosing diseases. But its most meaningful role may not be in laboratories or corporate boardrooms. It may be in homes — helping someone live safely, stay connected, and remain independent longer than was once possible.

The question is no longer whether technology will shape aging.

It already is.

The more important question is this:
How can we ensure it does so in ways that strengthen dignity, connection, and choice?

Rethinking What “Value” Means

For Jing Li, Associate Professor of Health Economics and Associate Director of The CHOICE Institute, the word “value” sits at the center of this conversation.

“In the current era,” she explains, “the unprecedented speed at which new technology develops — including advances in AI — has prompted policymakers, researchers, providers, and end users to look for ways to leverage these technologies to maximize their value.”

But value, she emphasizes, is not just about innovation.

“Value, at its core, involves both cost and benefit.”

That balance is broader than it sounds. Benefits include not only technical breakthroughs, but practicality, scalability, sustainability, and ease of use. Economists also look at what Li calls “marginal benefit” — the real, measurable improvement beyond what we already have. Does a tool meaningfully reduce falls? Improve medication adherence? Ease caregiver stress?

Costs are layered, too. There is the price of the technology itself, but also the time required to learn it, the adjustments in workflow, and the systems needed to support it. Trust and ethics, Li notes, cut across both sides of the equation. If people feel confident and respected, value increases.

The goal is not simply to build smarter tools. It is to build tools that make life better — in ways that are tangible and lasting.

Supporting the People Who Support Us

When we talk about aging, we often focus on older adults themselves. But caregiving is part of the picture — and often an invisible one.

For Karen Eggleston, Director, Asia Health Policy Program, Shorenstein Asia-Pacific Research Center, Stanford University, one of the most promising aspects of AI and robotics lies in how they can support care partners.

“One aspect that might be often overlooked,” she says, “is that AI and robotics can bring value to older adults through supporting their care partners — relieving the stress, time burden, or even the back pain of caregivers.”

That support can be transformative. A robotic lift that prevents injury. A digital platform that simplifies coordination. A monitoring tool that provides reassurance from a distance. Small improvements in caregiver burden can ripple outward — preserving energy, patience, and emotional bandwidth.

Eggleston underscores the importance of evidence to ensure these tools truly help. “For assessing value, it will be critical to gather evidence about what works in practice — including both the intended and unintended consequences.”

Done thoughtfully, technology has the potential to make care not only more efficient, but more humane.

Independence, With Support

For Shuai Huang, Professor, Department of Industrial & Systems Engineering at the University of Washington School of Engineering, the measure of success is clear.

“To define value in aging technology,” he says, “the primary metric should be how effectively a tool enhances an older adult’s quality of life, independence, and dignity — according to their own personal goals.”

That focus shifts the conversation. It reframes AI not as a replacement for human care, but as a partner.

“There’s a trade-off between a device providing ‘security’ for a clinician versus ‘surveillance’ for a senior,” Huang explains. Designing thoughtfully means ensuring safety without sacrificing autonomy.

Generative AI and digital tools are already enabling more proactive models of care. Sensors can detect subtle changes in routine. Predictive models can flag risks before they escalate. Virtual companions can supplement social engagement, especially for those aging alone.

The key, Huang believes, is inclusion. When older adults are invited into the design process — when their voices shape the tools meant to serve them — trust grows. The result is what one design participant described as an “ultimate partnership” — technology that feels made for me.

From Innovation to Real Life

In hospitals and long-term care settings, even the most promising technologies must prove themselves in the complexity of daily life.

For Oleg Zaslavsky, Director of the Digital Health Innovation Hub and Associate Professor in Aging, Biobehavioral Nursing at the University of Washington School of Nursing, value comes down to what people experience.

“Value should center on functional independence, caregiver burden, and quality of life — not just utilization or cost offsets,” he says. “True value in aging care must integrate both.”

AI now allows clinicians to detect patterns — changes in speech, movement, or behavior — that were previously invisible. That capability opens the door to earlier intervention and more personalized support.

At the same time, thoughtful implementation matters. Technology works best when it integrates smoothly into existing workflows and respects the people using it — from nurses to family members to older adults themselves.

When done well, these tools do not dominate the experience of aging. They recede into the background, quietly extending safety and support.

A Hopeful Future
If there is a through line in these conversations, it is this: technology should strengthen the experience of aging — not complicate it.

The most powerful tools may not be the flashiest or most visible. They may be the ones that quietly extend independence. The sensor that prevents a fall. The algorithm that catches a subtle health shift early. The digital platform that lightens a caregiver’s load. The interface that feels intuitive rather than intimidating.

Shuai Huang imagines a future in which AI becomes “an empowering, quiet partner — omnipresent yet never overbearing.” Success, he says, would sound like this: “I live alone, but I never feel alone or helpless.”

It is a modest vision, and that is precisely its strength.

Aging does not need to be reengineered. It needs to be supported — with tools that respect autonomy, preserve dignity, and make everyday life safer and more connected. When technology aligns with those goals, it expands choice rather than narrowing it.

The GenAI era offers extraordinary capability. The opportunity now is to apply that capability with care — designing systems that meet people where they are, that adapt to real lives, and that remain accessible beyond early adopters.

If we do that well, the future of aging will not feel futuristic at all.
It will feel steady. Supported. Human.

And perhaps most importantly, it will feel like life — continuing forward, with confidence and connection.

The IRA’s Impact on Long Term Care Pharmacy: Key Challenges and Policy Solutions

Portrait of Shiven Bhardwaj — Shiven Bhardwaj, PharmD, MAS

A new viewpoint article published in the Journal of Managed Care & Specialty Pharmacy examines how key provisions of the Inflation Reduction Act (IRA) of 2022 may unintentionally destabilize long‑term care (LTC) pharmacies—providers that serve many of the nation’s most vulnerable older adults.

The analysis, authored by PhD Candidate Shiven Bhardwaj and Associate Professor Douglas Barthold of the University of Washington School of Pharmacy’s CHOICE Institute, Weston Schmutz (Schmutz Health Solutions), and Jonathan H. Watanabe (University of California, San Francisco) evaluates how the law’s drug‑pricing reforms could create significant financial and operational challenges for pharmacies operating in LTC settings.

One of the paper’s central findings points to the projected impact of the IRA’s Maximum Fair Price (MFP) reimbursement structure. For drugs selected under the Drug Price Negotiation Program, LTC pharmacies could face an estimated 85% decline in revenue, a shift driven by reduced payments paired with already inadequate dispensing fees.

The researchers also highlight cash‑flow concerns arising from new Medicare Part D payment flows. Reimbursement timelines are expected to lengthen from roughly 14 days to 22–24 days, potentially creating liquidity shortfalls for pharmacies operating on narrow margins.

The article further notes that requirements tied to the IRA’s Monthly Prescription Payment Plan (M3P) are often incompatible with the retroactive billing processes common in long‑term care. These conflicts could increase administrative burden and introduce friction in medication access for residents.

Beyond identifying risks, the authors outline several policy recommendations designed to stabilize the LTC pharmacy sector. These include codifying refund amounts to maintain acquisition discounts, aligning reimbursement with value‑based care models, and implementing targeted adjustments to ensure continuity of care. The work was supported in part by the Plein Center for Aging.

The researchers emphasize that without policy responses, the future of LTC pharmacies and their essential functions may be jeopardized.

The full viewpoint article is available through JMCP at this link.

Three Decades of CHOICE: Honoring the Past, Shaping the Future

Thirty years ago, a quietly ambitious idea began to take shape at the University of Washington—one that would go on to redefine how we measure value in healthcare, train generations of leaders, and build a model for collaborative, human-centered research.

Today, The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute—stands as one of the world’s leading centers for health economics and outcomes research (HEOR). But its origins were humble. Its growth, deliberate. And its impact, profound.

The first graduating PhD cohort in 2001: Eric Johnson, Sean D. Sullivan, Todd Lee, Mitch Higashi, Dave Veenstra, Nui Chaiyakunapruk, Tom Hazlet, Holly Trautman, Jackie Gardner.

A Foundation of Vision: The Early Years

The story begins in 1989, when Dr. Andy Stergachis joined the UW School of Pharmacy. With a background in pharmacy and public health, Stergachis saw an opportunity to create something beyond the traditional academic mold. In 1990, he began laying the groundwork for what would become the Pharmaceutical Outcomes Research and Policy Program—PORPP, the academic forerunner to CHOICE. Stergachis envisioned an institute that would anchor rigorous graduate training in applied pharmaceutical outcomes research—and help shape pharmacy’s broader role in public health.

From the start, the work was policy-relevant and globally impactful. Stergachis’ own research helped shift World Health Organization guidelines on anti-malarial drug safety during pregnancy. The ethos was clear: CHOICE would be about science, but also service. “The field has grown, and CHOICE has grown with it,” he said. From substance use and tobacco cessation to maternal health and medical devices, CHOICE faculty and alumni are tackling the most complex issues in healthcare today—always with collaboration at the core. But Stergachis believes CHOICE’s most lasting contribution may be its people.

“Our alumni are change makers,” Stergachis said. “They’re leading in government, industry, and global health. That’s the legacy.”

He and his wife Joanne have helped ensure that legacy continues—through endowments supporting global learning, faculty leadership, and future scholars. “It’s about investing in the future,” he said. “Because we’re not done. Not even close.”

Building a Research Engine: The Rise of Outcomes Science

Soon, Stergachis was joined by epidemiologist Dr. Jackie Gardner, and pharmacist and recent PhD health economist from UC Berkeley, Dr. Sean D. Sullivan. Together, they formed a nucleus of scholars committed to rigorous science, collaborative inquiry, and the belief that pharmacy should be as much about population health as pills. When Sullivan arrived in 1991, the idea of evaluating “value for money” in healthcare was still novel, and they saw an urgent need to ask better questions in this space—and train people to answer them.

“CHOICE is a community,” Sullivan said. “A home for educators, researchers, and students who are passionate about improving health outcomes through better decision-making.”

Andy and Sean at that historic APhA Meeting — Andy and Sean at the historic APhA Meeting where the idea of PORPP was put into motion.

In 1995 the team, support, and funding were in place; the time was right to officially establish PORPP and a new graduate program. Under Sullivan’s leadership—as faculty, the Director of PORPP, and later dean—CHOICE helped pioneer the field of Health Economics and Outcomes Research (HEOR). Its graduate program became a launchpad for policy-influencing scientists. And its faculty—like Josh Carlson, Lou Garrison, Beth Devine, Dave Veenstra, Ryan Hansen, Aasthaa Bansal, and others—produced work that shaped real-world access, pricing, and regulation. “We’re often cited as a top institute globally,” Sullivan noted. “Not because of marketing—but because of the quality of our work, our dynamic students, and the staff behind it.”

The Institute’s impact can be seen in federal reforms, precision medicine policy, and groundbreaking cost-effectiveness methods. But its greatest influence, Sullivan said, may be its leadership pipeline: “Seven of the 30 ISPOR presidents have come from CHOICE. That’s not an accident. That’s a culture.”

Careers Defined: Purpose and Progress

For Dr. Beth Devine, CHOICE has been more than an academic home, it has been her purpose. “It wasn’t yet called CHOICE when I joined,” she recalled. “But the energy and ambition were unmistakable.”

PORPP scanned group photo from 1999 — Denise Boudreau, Shelby Reed, Kristin Marciante, Beth Devine

Across her career, Devine’s work has helped transform electronic health records, genomic screening, and evidence synthesis for national guidelines. She partnered across disciplines and continents, always keeping science in service to patients. “What sets CHOICE apart,” she said, “is that our research is never in isolation. It’s connected—to medicine, public health, informatics, and global policy.”

Reflecting on the evolution of CHOICE, Devine sees the next chapter of the Institute already underway. “We’re entering an era of real-world data, machine learning, and global collaboration,” she said. “But the core remains: rigorous, patient-centered science—and a culture of mentorship that multiplies our impact.”

Professor Emeritus Lou Garrison echoes Dr. Devine’s perspectives and is pleased to see the evolution and success of CHOICE over these 30 years and its contribution to the science of HEOR. Having mentored many students and junior colleagues, including Dr. Devine, he said, “I have had the privilege and pleasure of working with the dedicated and talented CHOICE faculty, students, and staff over this entire period—first, at Roche, as collaborator and mentor, and then, as a faculty member. My debt is immense—as is my gratitude for my good fortune.” In September 2022, Garrison received the Avedis Donabedian Outcomes Research Lifetime Achievement Award from ISPOR.

CHOICE Group Photo 2012 — 2012 Graduation Ceremony. Top row: Cara McDermott, Sean D. Sullivan, Beth Devine, Dave Veenstra, Josh Carlson, Denise Boudreau, Veena Shankaran. Bottom Row: Ryan Hansen, Heidi Wirtz, Jon Watanabe, Rafael Alfonso Cristancho, Josh Roth, Joanna Sanderson.

Dr. Josh Carlson, who serves as Graduate Program Director, sees collaborative culture as central to CHOICE’s success. “It’s not about individual excellence. It’s about building something together,” Carlson said.

His work with the Institute for Clinical and Economic Review (ICER) has led to more than 25 health technology assessment models used across the country. “It’s been a way to stay connected to both the policy implications and the methodological frontiers of our field. That dual relevance—rigor and impact—is what keeps CHOICE vibrant.”

A Broader Identity: Redefining Choice

Initial strategic plan brainstorming for The CHOICE Institute.

In 2014, when Sullivan became the Dean, he initiated the search for a new Director of PORPP. The search Committee, led by Andy Stergachis, identified Dr. Anirban Basu as the clear successor and he was appointed in 2015. At that time, the transformation from PORPP was already underway. But it was Basu who helped lead the redefinition. “Our faculty were working on vaccines, Alzheimer’s, financial behavior,” he said. “We needed a name—and an identity—that reflected that breadth.”

Brainstorming the CHOICE name — What’s in a name? Early brainstorming for PORPP’s new name: CHOICE.

Once CHOICE made its debut, it became an official university institute, unlocking broader scope and institutional support. Under Basu’s leadership, the Institute deepened its focus on real-world evidence, health insurance, and machine learning. Faculty like Noémi Kreif, Douglas Barthold, Jing Li, and Kyu Lee have brought new energy—and new questions.

“What sets CHOICE apart,” Basu said, “is that we train people not just to run models, but to interpret them. To connect economics, data, and ethics. That’s the work of a social scientist.”

He sees growing demand for that kind of thinking—and sees CHOICE rising to meet it.

“Healthcare is complex. Our job is to make sense of that complexity, and to train the next generation to do the same.”

A Culture of Belonging: Mentorship and Meaning

Since 1995, CHOICE has trained over 35 postdoctoral fellows, 90 master’s students, 84 PhD students, and more than 600 certificate students. CHOICE Institute alumni are a diverse community of experts who continue to shape the field—and their stories reflect the heart of the program.

Dr. Mark Bounthavong(’18) chose CHOICE not for the prestige—but for the people. He remembers entering the program with uncertainty, unsure whether he belonged in a rigorous PhD environment. But the culture he found at CHOICE quickly reshaped his expectations. “There were no stupid questions—only a shared mission to learn, grow, and contribute,” he recalled. “They made me feel like part of a team.”

That mentorship extended far beyond the classroom. When Bounthavong’s father passed away, it was CHOICE faculty and peers who reached out with support, compassion, and presence. “That meant the world to me,” he said. “It wasn’t just academic—it was deeply human.”

CHOICE alumni and students connecting at an ISPOR dinner organized by Mark Bounthavong in 2022.

Today, as an Associate Professor of Clinical Pharmacy at UC San Diego, Bounthavong sees his work and mentorship style as a direct reflection of what CHOICE instilled in him—modeling the same accessibility and generosity he received, and carrying the CHOICE ethos into new institutions and communities.

“We’re all products of this place,” Bounthavong reflects. “And the way we honor it is by paying it forward—by mentoring others, by spreading the values, and by building environments that feel like CHOICE, wherever we go.”

CHOICE Grads group photo — Felipe and his mentor Professor Basu at the 2025 Graduate Recognition Ceremony.

This culture of mentorship resonates with our most recent alumni. Dr. Felipe Montano-Campos (’25) shared, “For me, the most important part of CHOICE has been the mentorship and the chance to work with so many faculty across a range of topics. It also meant having the resources to attend conferences, meet more people in the field, and reconnect with CHOICE friends who are making their contributions all over the globe.”

As Felipe begins a Postdoctoral Fellowship at the University of Southern California, he carries with him memories of friendship and a soft spot for his home of the past four years. “When I think of CHOICE, I think of a group of incredibly respected researchers in the field—who also happen to be people I genuinely enjoy being around. And, of course, I can’t help but think of Seattle too.”

The People Behind the Progress

For Penny Evans, a longtime staff member who joined UW in 1991, CHOICE’s growth mirrored her own journey. When she first arrived, she had no idea she would be a part of one of the country’s leading centers for health economics, outcomes research, and policy.

“I became involved when they were developing the program,” she recalled. “I helped write and distribute the quarterly PORPP reports and then continued producing the annual reports until I retired. It was quite a journey.”

But her contributions extended well beyond reports and logistics. She welcomed new students, supported faculty research efforts, and helped organize national conferences. Through it all, she found joy and meaning in the relationships she built.

“The students were my favorite part,” Evans said. “They’re just phenomenal—so smart, so motivated. It gave me hope for the future.”

Penny’s last retreat as a full-time staff member prior to her retirement.

Though she retired in 2017, Penny Evans still carries her CHOICE memories with pride. “It was bittersweet to leave, but I was proud of what we built. And I know it’s in good hands—still growing, still evolving.” For Penny, CHOICE wasn’t just a workplace, it was a community that mattered—and still does. Her legacy lives on through the Penny Evans UW ISPOR Student Chapter Support Fund, established in 2017 to honor her lasting impact on the program. The fund supports student activities within the UW ISPOR chapter, fostering professional development and engagement with the global HEOR community.

Today, the administrative leadership of The CHOICE Institute is guided by Marina Gano, who joined in 2019 as the Graduate Program and Operations Manager. In 2023 she was joined by Leana de la Torre, serving as the CHOICE Online Certificate Manager. Their leadership, dedication, and genuine care for our students have helped carry forward Penny’s legacy and sustain the supportive culture that defines CHOICE.

Data and Decency: The New Generation Carries It Forward

Faculty such as Jing Li, Douglas Barthold, Kyu Lee, and Noémi Kreif are advancing CHOICE’s mission through innovative, data-driven research. At the same time, they remain deeply committed to the human-centered values that have long defined the Institute.

CHOICE Group Photo 2024 — CHOICE faculty, staff, and graduating students the 2024 SOP Graduate Recognition Ceremony.

Dr. Jing Li, Associate Director of CHOICE, reflects that commitment in her research, which spans Medicare policy, pharmaceutical marketing, and end-of-life care. “We’re asking hard questions—about how we define value, how incentives affect prescribing, how policy changes affect patients in the real world,” she said.

One of her recent studies on advance care planning showed how Medicare reimbursement shifted end-of-life outcomes for patients, which has opened new national healthcare practice discussions on how policy can align with patient preferences. “That’s what we strive for—research that not only advances knowledge, but helps people live better lives.”

Douglas Barthold, Associate Graduate Program Director, brings a health policy lens to his work on chronic disease management and cognitive decline. He emphasizes the importance of interpretation and empathy in a field increasingly driven by data.

“AI is coming,” Barthold said. “But we have to teach what machines can’t: judgment, critical thinking, compassion. That’s the heart of our teaching mission.”

CHOICE faculty at ISPOR 2025 in Montreal.

Through complex simulation modeling, Kyu Lee’s work forecasts the future burden of diseases and how sound health policies can mitigate their impact on individuals and communities. Her latest research, focused on optimizing the timing of seasonal influenza vaccine selections, exemplifies the power of interdisciplinary and international collaboration by bringing together global experts in decision science, epidemiology, and clinical medicine.

Noémi Kreif adds another dimension to CHOICE’s evolving research landscape by combining causal inference and machine learning to improve health policy and economic evaluations. Her work focuses on using healthcare data in flexible, equitable ways to inform personalized decision-making. She is also deeply committed to training the next generation of graduate students and researchers.

CHOICE’s impact is felt not only through its research, but also in the experiences of the students who shape and are shaped by the program. Current PhD students Karris Jeon, Carlos Pineda-Antunez, and Satoshi Koiso share what drew them to CHOICE—and what makes it stand out.

Jeon shared, “As someone who came to the U.S. for a PhD program, CHOICE has been a gateway to new and diverse ideas—and a community of kind, brilliant people, where purpose meets possibility.”

Koiso added, “I chose CHOICE because of its close-knit community, the diversity of its students and faculty, and its strong commitment to impactful research that contributes to society. This combination of a supportive environment and meaningful work felt unique compared to other programs.” And for Pineda-Antunez, the decision was simple: “Once I made my choice, I loved my CHOICE!”

Together, this new generation is exploring the intersection of economics, innovative methods, equity, and human behavior—expanding the scope of CHOICE while upholding its enduring mission.

As Li puts it, “This is where ideas grow—and where people support each other in making them better.”

Looking Forward

CHOICE Faculty, Staff, and Students – May 2024

As the institute marks its 30th anniversary, its legacy is clear. Not only in the research it produces or the policies it informs—but in the people it has trained, the questions it has asked, and the values it has carried forward. Basu is clear-eyed about what lies ahead for the institute. “Healthcare inefficiencies aren’t going away. The pressure to improve outcomes and control costs will only grow. And CHOICE is uniquely positioned to contribute to that conversation, both nationally and globally.”

And as for what makes it all worth it?

“Coming to work every day with people who care deeply, who challenge you, who make your ideas better—that’s what CHOICE is,” Basu said. “And that’s why it matters.”

Authored by Scott Braswell, with our appreciation for bringing this piece to life.

Professor Anirban Basu Receives 2025 HEOR Excellence–Application Award

Anirban Basu, Stergachis Family Endowed Director and Professor of Health Economics, has received the 2025 Health Economics and Outcomes Research (HEOR) Excellence–Application Award from ISPOR – The Professional Society for Health Economics and Outcomes Research.

The award recognizes Basu’s paper, “Gene Therapy Versus Common Care for Eligible Individuals With Sickle Cell Disease in the United States,” which was developed in collaboration with faculty, students, and postdoctoral researchers at the CHOICE Institute and funded by the National Heart, Lung, and Blood Institute’s Cure Sickle Cell Initiative. The study was published in Annals of Internal Medicine and explores the comparative impact of gene therapy versus standard care for individuals with sickle cell disease in the U.S.

Basu was acknowledged during the ISPOR Awards Ceremony at ISPOR Europe in November 2025.

This award is given to research that demonstrates practical application of health outcomes research and is expected to influence health policy or healthcare decision-making. ISPOR gives preference to work that applies health economics methods to areas such as health technology assessment, policy evaluation, and other topics aligned with the Society’s mission.

Read more about the ISPOR Scientific Achievement and Leadership Awards: https://www.ispor.org/about/awards-grants/scientific-achievement-and-leadership-awards

Anirban Basu receiving the ISPOR award on stage, smiling and holding the trophy. — Anirban Basu presented with the award at ISPOR Europe 2025 by ISPOR President (2025-2026) Uwe Siebert.

Welcome Department of Pharmacy Assistant Professor, Jessica Beers

A very special welcome to new Department of Pharmacy Assistant Professor, Dr. Jessica Beers, who officially joined the School September 2. Dr. Beers earned her PharmD in 2018 from Lipscomb University College of Pharmacy and completed her PhD in Pharmaceutical Sciences in 2023 at the University of North Carolina at Chapel Hill. She is passionate about improving drug safety in understudied populations, and her previous research has focused on precision medicine, drug-induced liver injury, and the use of advanced cell culture models to predict drug metabolism and toxicity. Her current work integrates both basic and clinical research to investigate drug metabolism and disposition during pregnancy and lactation.

PhD Candidate Emma Cousin Co-Authors Health Affairs Article on Medicare Drug Pricing

Emma Cousin

A Health Affairs Forefront article, “Blockbusters and Loopholes: Expanding Exemptions in Medicare Drug Price Negotiations,” examines how certain high-cost “blockbuster” drugs may avoid Medicare’s Drug Price Negotiation Program (DPNP) as a result of a small provision in the One Big Beautiful Bill Act (OBBBA), signed into law July 2025 by the Trump administration. The provision broadens the definition of “orphan drugs” under the DPNP, ultimately excluding them from negotiation or delaying their eligibility. The article illustrates which drugs impacted by OBBBA would have otherwise been eligible for selection in 2026 and 2027 under the DPNP.

“This research demonstrates that the provisions in the OBBBA impact the eligibility of several blockbuster drugs, such as Keytruda and Darzalex, leading to rippling effects in how much Medicare will save from the Medicare Drug Price Negotiation Program and ultimately patient access.” -Emma Cousin, PharmD, 4th Year PhD Candidate and Co-Author

This work was authored by Professor Sean D. Sullivan, BScPharm, PhD and CHOICE PhD Candidate Emma M. Cousin, PharmD, in collaboration with Kristi Martin, MA, MPA.

Read the article in Health Affairs Forefront: https://www.healthaffairs.org/content/forefront/blockbusters-and-loopholes-expanding-exemptions-medicare-drug-price-negotiations.

Five CHOICE Students Awarded Plein Center for Aging Scholarships

The Plein Center for Aging is a global leader in transformative pharmacy research, education, and outreach. Committed to optimizing medication outcomes for older adults and promoting healthy aging, the Center supports innovative work at the intersection of pharmacy and aging. This year, five CHOICE graduate students were awarded Plein Center scholarships—an opportunity designed to foster student engagement in aging-related research.

Preetika Banerjee, 2nd year PhD Student

Exploring the Relationship Between Antiviral Treatment and Antibiotic Prescribing for Respiratory Illnesses in Older Adults: A MEPS-Based Analysis

Preetika’s research focuses on the intersection of antiviral use and antibiotic prescribing in older adults with respiratory viral infections. Using nationally representative data from the Medical Expenditure Panel Survey (MEPS), Preetika will examine whether early antiviral treatment, such as Paxlovid or Tamiflu, reduces the likelihood of inappropriate antibiotic use during subsequent illness episodes. This work addresses an important gap in antimicrobial stewardship by evaluating how timely antiviral therapy may help curb unnecessary antibiotic prescribing, a key driver of antimicrobial resistance. She will also investigate which patient and provider characteristics are associated with inappropriate antibiotic use, using predictors like frailty, comorbidities, and healthcare access. The goal is to generate real-world, policy-relevant evidence to inform safer, more effective prescribing practices for older adults, a population that disproportionately experiences the harms of both infection and medication overuse.

Dr. Shiven Bhardwaj

Shiven Bhardwaj, 4th year PhD Student

Assessing Impact of the Inflation Reduction Act on Long Term Care Pharmacies

Passed in 2022, the Inflation Reduction Act (IRA) includes provisions designed to lower Medicare Part D spending and improve prescription affordability. Several of these policies indirectly affect Long-Term Care (LTC) pharmacies. Shiven will systematically examine these provisions, highlighting their intended and unintended impacts on LTC pharmacies. He will also outline measures that the Centers for Medicare & Medicaid Services (CMS) have taken to mitigate potential harms, along with additional steps needed to ensure seniors continue receiving high-quality LTC pharmacy services

Julia Fox

Julia Fox, 4th Year PhD Student

Investigating Disparities in Healthcare Utilization and Outcomes for Sexual Minority Older Adults

Julia Fox will be leveraging Medicare claims data linked with data from the Health and Retirement Survey (HRS) to investigate differences in rates of potentially inappropriate medications, polypharmacy, medication-related problems, and adverse drug events between sexual minority older adults and heterosexual older adults. As sexual minority older adults are less likely to have family caregivers and report higher anxiety about engaging with healthcare professionals, she aims to study if those differences impact pharmaceutical utilization and pharmacological outcomes. Results will additionally be analyzed by dementia status to determine if differences are exacerbated by the condition. She is deeply grateful to the Plein Center for supporting this important research.

Ben Nwogu

Ben Nwogu, 5th Year PhD Student

Comparative Effectiveness of Multiple Treatments for Metastatic Hormone-Sensitive Prostate Cancer (mHSPC): A Target Trial Emulation Using Claims Data

Ben Nwogu is addressing a critical gap in cancer care for older adults through his innovative research on novel therapies for metastatic hormone-sensitive prostate cancer (mHSPC). Leveraging rich real-world data, he expertly combines the target trial emulation framework with advanced machine learning methods to evaluate survival outcomes among patients treated with androgen deprivation therapy (ADT) in combination with abiraterone, apalutamide, enzalutamide, or docetaxel. By comparing these four treatment strategies, his study addresses an important evidence gap resulting from the absence of head-to-head randomized clinical trials directly evaluating these therapies. His findings will generate robust real-world comparative effectiveness data to support evidence-based treatment decisions by clinicians and patients, while also informing clinical guidelines and policy recommendations.

Olivia Yip, 2nd Year MS Fellow

Cost-Utility Analysis of Non-Prescription Oseltamivir for Influenza Treatment

Influenza is a viral respiratory infection that causes significant morbidity and mortality in older adults. Oseltamivir, when initiated within 48 hours of symptom onset, has been shown to reduce the duration of symptoms and the risk of serious complications. However, the current requirement for a prescription can delay treatment initiation, limiting its potential benefit. With increasing availability of rapid diagnostic tests, reclassifying oseltamivir to be available without a prescription following a positive influenza test may improve timely access and utilization. To evaluate this strategy, Olivia is conducting a decision-analytic modeling assessing the cost-effectiveness of oseltamivir reclassification from both the U.S. healthcare sector and limited societal perspectives. The hope is that this work would help facilitate earlier initiation of antiviral therapy and reduce influenza-related complications, hospitalizations, and healthcare expenditures among older adults.

Julia Fox presented her work at the 2025 Plein Center Research Symposium

CHOICE Researchers Examine Effects of Cancer Treatment Advancements on Health Disparities

Are new cancer treatments benefiting everyone equally? A new study published in JCO Advances, led by CHOICE alumni Dr. Sara Khor (’24) and CHOICE faculty Dr. Josh Carlson, Dr. Aasthaa Bansal, and Dr. Anirban Basu, along with Dr. Veena Shankaran from Fred Hutchinson Cancer Center, reveals that while new therapies for advanced lung cancer and melanoma have significantly improved survival rates, they have also widened survival disparities based on area-level income levels. This raises important concerns about how these innovations may exacerbate existing disparity gaps in health outcomes.

The research analyzed data from over 357,000 adults diagnosed with advanced cancers between 2007 and 2016. It found that new treatments led to a 3.7 percentage point increase in two-year survival for lung cancer patients and a remarkable 16.8 percentage point increase for melanoma patients. However, the survival improvements were not equal; patients in low-income counties experienced less benefit compared to those in high-income areas. Specifically, the approval of targeted therapies and immunotherapies was associated with increased survival disparities of 2.4 percentage points for lung cancer and 6.1 percentage points for melanoma.

Figure 3A: Observed lung cancer disparity in 2-year survival across county-level income level over time, measured in absolute difference, and the expected disparity in the absence of the innovations. Vertical dark green lines indicate the time when an innovation was approved by the Food and Drug Administration.

The researchers call for a reevaluation of drug pricing, coverage policies, and dissemination strategies to ensure that all patients, regardless of socioeconomic status, can access the latest treatments. They stress the importance of integrating equity considerations into healthcare policies and addressing the broader structural factors contributing to these inequalities.

“As the healthcare community continues to innovate, it is crucial to ensure that advancements in cancer treatment do not leave behind the most vulnerable populations.” says Khor.

Read the full study here: https://ascopubs.org/doi/10.1200/OA-25-00026.

Celebrating the Excellence and Impact of Our 2025 Student Award Honorees

At the UW School of Pharmacy, excellence takes many forms. We celebrate not only academic success and groundbreaking research, but also the passion, initiative, and innovation our students bring to every challenge. This month, we’re proud to honor six exceptional students who embody the very best of our community through their creativity, leadership, and dedication to making a difference.

HUI-HSUAN CHAN – 2025 MAGNUSON SCHOLAR

CHOICE PhD student Hui-Hsuan Chan was selected as the School’s 2025 Magnuson Scholar—an honor presented annually to one student from each of UW’s six Health Sciences schools. Funded by the Warren G. Magnuson Institute, the award recognizes both academic achievement and the potential for impactful research in fields like diabetes and public health.

“I’m honored to be selected as a 2025 Magnuson Scholar representing the School of Pharmacy,” Hui-Hsuan said. “This award provides generous support for my continued research into improving healthcare sustainability and managing high-cost chronic conditions like diabetes. I’m grateful for the opportunity to contribute to meaningful, lasting impact.”

ZIZI ELSISI – OUTSTANDING DISSERTATION AWARD

Zizi Elsisi, a PhD graduate of the CHOICE Institute, was honored with the 2025 Outstanding Dissertation Award for her rigorous and timely work on subscription-based payment models for Hepatitis C treatment in Louisiana and Washington.

“It’s an incredible honor to receive the Outstanding Dissertation Award for my research on subscription-based payment models for hepatitis C treatment in Louisiana and Washington,” Zizi said. “This work highlights how innovative financing strategies can improve access to cure medications for vulnerable populations. I’m proud to contribute to research that bridges policy and real-world impact. I’m especially grateful to my advisor, Dr. Anirban Basu, and the CHOICE Institute for their invaluable mentorship and support throughout this journey.”

CHRIS ARIAN – OUTSTANDING DISSERTATION AWARD

Chris Arian, from the Department of Pharmaceutics, also received the 2025 Outstanding Dissertation Award for his development of an intestinal microphysiological system (MPS) using a long-term cultured enteroid monolayer model. His innovative research is poised to significantly advance the field of drug metabolism and drug–drug interaction (DDI) prediction.

“It is an incredible honor to receive the School of Pharmacy’s Outstanding Dissertation Award,” said Chris. “Achieving this award would not have been possible without the support of my mentors, Dr. Ken Thummel and Dr. Ed Kelly, my partner Marelle for her encouragement and presence in my life, and my lab mates for their friendship and scientific discussions.”

AURORA AUTHEMENT – GRADUATE STUDENT LEADERSHIP AWARD (PHARMACEUTICS)

PhD candidate Aurora Authement was recognized with the School’s 2025 Graduate Student Leadership Award for her outstanding contributions to the Pharmaceutics Department and her mentorship within the student community.

“I’m honored to receive the Graduate Student Leadership Award,” said Aurora. “This recognition affirms the importance of fostering an inclusive, collaborative scientific community, and I’m grateful for the opportunity to contribute to the growth and success of my peers. I’m also deeply thankful to my mentors, including Ken Thummel and Nina Isoherranen, whose guidance and support have been instrumental in shaping my development as a leader.”

ALESI ESCOBEDO – GRADUATE STUDENT LEADERSHIP AWARD (MEDICINAL CHEMISTRY)

Medicinal Chemistry PhD candidate Alesi Escobedo was selected for the 2025 Graduate Student Leadership Award in recognition of her exceptional service, mentorship, and positive impact across the department.

“I’m truly honored to receive this award,” said Alesi. “It’s been a privilege to contribute to our department and support the next generation of scientists coming up behind me. Receiving this recognition reinforces my belief that a supportive community empowers us all to grow and succeed together.”

TORI DAYER – GRADUATE STUDENT LEADERSHIP AWARD (CHOICE)

Tori Dayer, PharmD and current PhD student at the CHOICE Institute, received the 2025 Graduate Student Leadership Award for her lasting impact on the program and her peers.

“Being part of the CHOICE and School of Pharmacy community has continually inspired me to grow and collaborate,” Tori said. “I am very honored to receive this award and to have had the opportunity to contribute to such a wonderful community!”

These students represent the best of what our School stands for: academic excellence, leadership, and a deep commitment to improving healthcare for all. Please join us in congratulating Hui-Hsuan, Zizi, Chris, Aurora, Alesi, and Tori on their outstanding accomplishments. Their work is shaping the future of pharmacy and public health—and we couldn’t be prouder.

Hui-Hsuan Named 2025 Magnuson Scholars Award Recipient

The UWSoP is proud to announce that CHOICE PhD student Hui-Hsuan Chan was selected last month as a 2025 Magnuson Award recipient. With a keen interest in improving healthcare sustainability through robust health economics research, Hui-Hsuan focuses on managing high-cost chronic conditions like diabetes in an effort to alleviate their economic burden.

As Jason Lindahl, the UW’s Director of Health Sciences Services explains, “each scholar was nominated by their respective school – Dentistry, Medicine, Nursing, Pharmacy, Public Health and Social Work – on the basis of outstanding academic performance and potential contributions to research in the health sciences.” Each scholar will receive $34,000 to support their education and research in the upcoming year.

The Magnuson Scholars Award is presented annually to one outstanding student from each of the six UW Health Sciences schools: Dentistry, Medicine, Nursing, Pharmacy, Public Health, and Social Work. Funded by the Warren G. Magnuson Institute, the award recognizes academic excellence and the potential to advance impactful research in health sciences, particularly in areas such as diabetes and public health. It also provides generous financial support for continued training and research.

Manpreet Dhankhar Named 2025 Bonderman Fellow

We’re excited to share that Manpreet Dhankhar, a PhD student from The CHOICE Institute, has been selected as a 2025 Bonderman Fellow. Manpreet is one of just two students from the UW School of Pharmacy to have received this fellowship since its inception.

As part of the program, Manpreet will receive $26,000 to travel independently for eight months through at least two regions of the world. Fellows are encouraged to explore new places, engage with different cultures, and learn from the experience — without the structure of academic study or research.

Manpreet’s travel goals are rooted in a desire to explore how craft, tradition, and identity intersect across cultures. With a background in pottery and textiles, she is particularly interested in how everyday creative practices are woven into the rhythms of daily life and how they reflect care, memory, and cultural preservation. Her current proposed itinerary includes Vietnam, Thailand, India, South Korea, Japan, Cambodia, Argentina, and Chile.

“This fellowship will allow me to immerse myself in vastly different cultures and to learn from the lived experiences, perspectives, and histories of people in other countries,” Manpreet said. “As someone whose work in the School of Pharmacy is shaped by global public health questions, stepping out of my comfort zone and experiencing new perspectives firsthand will no doubt influence my research, deepen my understanding of the world, and shape who I am as a person.”

The Bonderman Fellowship was established in 1995 by UW alumnus David Bonderman to support meaningful international travel for students. Since then, it has helped hundreds of Huskies broaden their horizons and reflect on their place in the world. Following Mr. Bonderman’s passing in December 2024, this year’s fellows continue to carry forward his vision.

“It’s a very exciting opportunity, and I’m grateful for the chance to grow as I undertake this journey,” Manpreet said.

Congratulations to Manpreet on this well-deserved honor — we look forward to following the journey ahead.

CHOICE Researchers Examine Oncologist-Patient Concordance and Treatment Adherence in Chronic Myeloid Leukemia

In their new JAMA Network Open study, PhD candidate Felipe Montano-Campos, Associate Professor Aasthaa Bansal, and co-authors tracked 5 years of monthly tyrosine kinase inhibitor (TKI) adherence in chronic myeloid leukemia (CML) patients.

“After adjusting for patient and provider characteristics — including differences in oncology practice styles — we found that oncologist-patient concordance (i.e., shared identity traits) was associated with higher and more sustained adherence over time” says Felipe.

To rule out the possibility that concordant relationships were driven by patient selection or provider sorting, the team formally tested whether concordance was associated with underlying clinical, sociodemographic, or care-seeking characteristics. It was not — the association with adherence remained robust.

This is one of the first studies to isolate the long-term behavioral impact of patient-provider concordance in real-world oncology care.

Figure. Treatment adherence trends by race and ethnicity and gender concordance — Treatment adherence trends by race and ethnicity and gender concordance

Read the full article.

This research was supported by grant R37-CA218413 from the National Cancer Institute of the National Institutes of Health.

The Future of Community Pharmacy Depends on Advocacy

According to Dr. Jennifer Bacci, community pharmacies are at a crossroads and advocacy is the key to ensure their survival.

In a recent interview with Drug Topics, Bacci – endowed associate professor of Innovative Pharmacy Practice – emphasized the urgent need for policy support and collaboration across healthcare professions to sustain community pharmacy services.

With pharmacists playing an essential role in accessible, patient-centered care, challenges like reimbursement issues and workforce shortages threaten their ability to provide critical services.

Bacci highlights how interprofessional support and legislative action can help strengthen pharmacies as frontline healthcare providers, ensuring patients continue to receive the care they need, when and where they need it.

Get the complete conversation on DrugTopics.com.

Clayton English Named AAPP Fellow for Leadership in Psychiatric Pharmacy

At the UW School of Pharmacy, innovation and compassion go hand in hand – just ask Assistant Professor Dr. Clayton English, whose dedication to advancing mental health care and psychiatric pharmacy has earned him recognition as a 2025 Fellow of the American Association of Psychiatric Pharmacists (AAPP).

English’s journey – from a small-town pharmacy to a leading educator, researcher and advocate – is deeply intentional. “My life has been touched by close friends whose lives had been turned upside down by behavioral health issues,” he shared. “That spurred me to wanting to know more and to learn more in that area and find out if there was a role for pharmacists in that arena.” His work is all the more vital as millions of Americans navigate mental illness in times marked by economic stress, political upheaval and global uncertainty.

With broad clinical and research interests spanning psychiatric medication safety, deprescribing, mood disorders, adult ADHD and drug-induced behavioral conditions, English is a champion for interprofessional education, team-based care and student well-being.

His leadership extends beyond the classroom, too; English is a Senior Editor for the AAPP Psychiatric Pharmacotherapy Review Book and has been recognized nationally for his excellence in teaching, mentorship and advocacy for the pharmacy profession. Last month, he moderated a panel discussion on the groundbreaking intersection of addiction medicine and psychedelic therapies at Husky Days in the Bay. Joined onstage by experts from UW Medicine, UC Berkeley and UC San Francisco, English led a dynamic conversation on the transformative potential of psychedelics to address substance use disorders for Bay Area UW alumni.

The inaugural cohort of the AAPP fellowship honors professionals who’ve made a lasting impact on psychiatric pharmacy, advancing the practice setting with service and leadership.English will be formally recognized at the 2025 AAPP Annual Meeting in Salt Lake City this spring – a well-earned distinction for an educator and advocate whose work is shaping the future of medication therapy for behavioral health.

New Research Highlights the Full Economic Burden of Alzheimer’s Disease

A recent study published in Value in Health by Julia Fox – a 3^rd year PhD student at the CHOICE Institute – and coauthors reveals the staggering indirect costs of Alzheimer’s disease (AD), emphasizing the financial impact of unpaid caregiving and lost productivity across all stages of the disease.

They find that total annual indirect costs increase significantly with disease progression, ranging from $36,934 for mild cognitive impairment due to AD to $145,250 for severe AD. In total, these indirect costs amount to approximately $832 billion per year in the United States, including $599 billion in unpaid caregiving costs and $233 billion in productivity losses.

This study underscores the importance of incorporating indirect costs—such as caregiver burden and patient productivity loss—into economic evaluations of AD treatments. These findings provide critical support for including indirect costs in cost-effectiveness modeling and healthcare decision-making.

Publication: https://www.valueinhealthjournal.com/article/S1098-3015(24)06759-7/fulltext

Anirban Basu publishes JAMA article on Mitigating Clinical Algorithmic Discrimination

There is significant concern that the growing use of algorithms in clinical practice can exacerbate health disparities by perpetuating discriminatory recommendations embedded in such algorithms.

In a recent Viewpoint article published in JAMA Health Forum, Anirban Basu – Professor of Health Economics and Stergachis…

Jennifer Bacci Named a 2024 NAM Fellow

The National Academy of Medicine (NAM) has selected the UW School of Pharmacy’s Jennifer Bacci, Endowed Associate Professor in Innovative Pharmacy Practice, as one of seven outstanding health professionals for the class of 2024 NAM Fellowships. The fellows were chosen based on their professional qualifications, reputations and accomplishments, and the relevance of their current field expertise to the work of the NAM and the National Academies of Sciences, Engineering, and Medicine.

The fellows will collaborate with eminent researchers, policy experts, and clinicians from across the country during their two-year fellowship. They will also participate in initiatives convened by the National Academies to provide nonpartisan, scientific, and evidence-based guidance to policymakers, academic leaders, health care administrators, and the public.

“I am delighted to welcome these exceptional health science scholars into the NAM Fellowship program,” said National Academy of Medicine President Victor J. Dzau. “The fellows will play an active role in our process of developing comprehensive policy solutions to provide health advice to the nation and globally, and will gain access to a network of mentors to support them throughout their careers.”

Fellows will continue in their primary academic or research posts while engaging part time over a two-year period in the National Academies’ health and science policy work. They will also work with an expert study committee or roundtable related to their professional interests, including contributing to reports or other products. A flexible research grant will be awarded to every fellow.

The overall purpose of the NAM Fellowship program is to enable talented, early-career health science scholars to participate actively in the work of the NAM and the National Academies, and to further their careers as future leaders in the field.

The National Academy of Medicine, established in 1970 as the Institute of Medicine, is an independent organization of eminent professionals from diverse fields including health and medicine; the natural, social, and behavioral sciences; and beyond. It serves alongside the National Academy of Sciences and the National Academy of Engineering as an adviser to the nation and the international community. Through its domestic and global initiatives, the NAM works to address critical issues in health, medicine, and related policy and inspire positive action across sectors. The NAM collaborates closely with its peer academies and other divisions within the National Academies of Sciences, Engineering, and Medicine.

The CHOICE Institute and Department of Pharmacy Welcome Dr. Noémi Kreif to the Faculty

Dr. Noémi Kreif, MA, MS, PhD joined the CHOICE Institute and the Department of Pharmacy in March as an Assistant Professor. She joins us most recently from the University of York Centre for Health Economics (CHE) where she was a Senior Research Fellow in Health Economics. Dr. Kreif earned a PhD in Health Economics in 2013 at the London School of Hygiene and Tropical Medicine (LSHTM), University of London (UK). Dr. Kreif also holds an MA in Economics from Central European University, Hungary and an MSc in Economics from Corvinus University of Budapest, Hungary.

Dr. Kreif has an established publication and funding track record in methods-focused and applied health economics research. She is passionate about bridging the gap between health economics/health policy research and modern causal inference. She has developed a research agenda that centers on innovative causal inference methodology, collaborating with researchers from various fields, including global health and decision science, as well as psychiatry and computer science.

Dr. Kreif’s early (PhD and post-doctoral) research, conducted at the London School of Hygiene and Tropical Medicine focused on statistical methods underpinning cost-effectiveness analyses that use observational data. Later, at the University of York she developed a research agenda in global health economics, focused on health policy issues in low- and middle-income countries, such as the heterogenous policy impacts of national health insurance reforms in Indonesia, or the health impacts of civil conflict in Colombia.

Dr. Kreif’s current research focuses on combining causal inference and machine learning methods to improve health policy evaluations and economic evaluations by using healthcare data in flexible ways to inform personalized decision making that considers resource and equity constraints. Her most recently awarded research grant allowed her to lead a team that brought together expertise from health economics, causal inference, decision science, and computer science. She is passionate about training a new generation of graduate students and researchers in modern causal inference and computational statistics methods. Dr. Kreif is open to advising MS and Ph.D. students conducting research on a wide range of topics, including using real-world data for comparative effectiveness research and health policy analysis and incorporating machine learning into health outcomes research for stratified decision making.

Google Scholar: https://scholar.google.com/citations?user=L7MMYvwAAAAJ&hl=hu

Faculty Page: https://sop.washington.edu/people/noemi-kreif/

Aaron del Pozo Sanz Awarded AES Fellowship for Epilepsy Research

Congratulations to Aaron del Pozo Sanz, a post-doctoral scholar at the University of Washington School of Pharmacy’s Barker-Haliski Lab!

Aaron has been awarded a 2023 Early Career Postdoctoral Research Fellowship from the American Epilepsy Society (AES) funded through Partners Against Mortality in Epilepsy (PAME). This fellowship recognizes Aaron’s outstanding dedication and contributions to epilepsy research.

The American Epilepsy Society’s commitment to supporting trainees, fellows, and new investigators working on various aspects of epilepsy research, from basic science to translational and clinical studies, is commendable. By providing vital research dollars, AES plays a crucial role in advancing knowledge and finding effective treatments for all types of epilepsy, seizures, and related conditions.

To gain insight into his work and the significance of this fellowship, we had the privilege to interview Aaron and ask him a few questions:

Q: What research will this fellowship be funding?

A: This research aims to find a cure for the Sudden Unexpected Death in Epilepsy (SUDEP). SUDEP is a significant and often under-recognized public health concern with considerable relevance in society that refers to the sudden, unexpected death of an individual with epilepsy, occurring without an apparent cause during or immediately following a seizure. This devastating outcome affects not only the person with epilepsy, but also their families, friends, and the wider community.

Q: What is the goal for your research?

A: Overall, this proposal aims to describe by video-EEG monitoring the mortality features of Transgenic mice subjected to chronic evoked seizures. Moreover, I aim to pharmacologically prevent the mortality using two different pharmacological strategies: using lorcaserin, a 5-HT2C receptor agonist or cannabidiol, a broad-spectrum anti-inflammatory and serotonin modulator recently approved in other SUDEP disorders such as Dravet Syndrome.

Q: What is the most exciting for you about this fellowship and what are you hoping to learn?

A: The most exciting part of this fellowship is to uncover other SUDEP models and medicines that can exert a significant impact in the understanding and comprehension of SUDEP. I hope to achieve the following skills:

To acquire a comprehensive understanding of the underlying mechanisms and risk factors that contribute to SUDEP.
To enhance my research skills and methodologies, honing my ability to design rigorous studies, analyze data, and interpret results accurately.
To work closely with esteemed researchers, clinicians, and experts in epilepsy and related disciplines. Engaging in fruitful collaborations will facilitate the exchange of ideas, foster innovative thinking, and create a supportive network that enhances the impact of our collective efforts.
To explore the translational aspects of my research. My goal is to bridge the gap between research findings and real-world applications, seeking potential avenues for preventive measures, interventions, or treatments that can be applied in clinical settings to reduce the risk of SUDEP.
To engage with individuals and families who have been affected by epilepsy and SUDEP. Through these interactions, I hope to develop a deeper sense of empathy and understanding of the challenges they face, driving me to become a passionate advocate for improving the lives of those impacted by epilepsy and raising awareness about SUDEP in the wider community.
To share the knowledge and insights gained from this fellowship with the broader scientific community and the public. Through publications, presentations, and outreach initiatives, I hope to create awareness about SUDEP and contribute to a positive impact on public health policies and clinical practices.

Q: What does receiving this fellowship mean to you?

A: Receiving this fellowship is a deeply profound and personally significant milestone in my life. It represents an incredible opportunity to make a tangible impact on the lives of countless individuals living with epilepsy, as well as their families and communities. The gravity of this fellowship’s purpose resonates deeply with me, and it evokes a sense of purpose and responsibility that I carry with utmost dedication and passion.

Furthermore, it is s a recognition of the potential impact my work can have in advancing our understanding of SUDEP and, most importantly, in developing effective treatments or interventions. It bolsters my resolve to contribute to the scientific community’s collective efforts in unraveling the complexities of epilepsy and working towards a future where no one has to face the fear of sudden, unexplained deaths due to seizures.

On a personal level, this fellowship represents a unique chance to give back to society in a way that holds immense significance. It fuels my desire to contribute positively to the lives of others and to work tirelessly towards alleviating the burden that SUDEP places on individuals and their families.

Learn more about the 2023 fellowship awardees here.

SOP Faculty Present Research at ISS Conference

Ed Kelly (left) and Cathy Yeung (right) with Astronaut Megan McArthur (center) at this year’s ISSRDC meeting

Drs. Ed Kelly (Department of Pharmaceutics) and Cathy Yeung (Department of Pharmacy) recently attended and presented their research at the International Space Station Research and Development Conference (ISSRDC) held in Seattle August 1-3.

Drs. Kelly and Yeung (with co-PI Jonathan Himmelfarb, Kidney Research Institute) received funding from NCATS and NASA to study the effects of microgravity on kidney function by sending their kidney microphysiological system to the International Space Station on two separate missions aboard SpaceX rockets (CRS-17 & CRS-22).

https://www.issconference.org/

PharmD Student Receives US Public Health Pharmacy Award

UWSOP PharmD student Ruger Stufflebeam has been selected for the 2023 United States Public Health Service Excellence in Public Health Pharmacy Award!

This award recognizes pharmacy students who make significant contributions to public health, including advancing the objectives of Healthy People 2030, the Surgeon General’s priorities, and the pharmacy profession.

Nominated by UWSOP faculty, Ruger was chosen for his pivotal role in advancing pharmacy and public health services for the people in Skagit County. He designs collaborative pathways with local providers and reimagines pharmacy workflow to enhance services, including COVID-19 immunizations and treatment, training staff, assessing program outcomes and incorporating improvements to enhance service quality.

“I am not accepting this award as an individual, but as a representative of the amazing teams I have been a part of,” said Ruger, who is currently interning at Schaffner Pharmacy in Sedro-Woolly, WA. “The work we did in Ghana and the work we are doing at Schaffner Pharmacy share the common goal of improving healthcare access for vulnerable populations.”

“While there remains substantial work ahead of us, this award signifies we are heading in the right direction.”

Ruger will be presented the formal award at the School of Pharmacy Graduate Recognition event in June 2023.

Area High School Students STEP Toward a Career In Pharmacy

The 2022 edition of the Students Exploring Pharmacy (STEP) program recently welcomed 30 local high school juniors and seniors to the University of Washington campus. Each year, the 4-day program invites students to engage in hands-on activities that provide an introduction to pharmacy practice and pharmaceutical sciences and offer a fresh perspective on how pharmacists contribute to improving the health of a community in ways that go far beyond dispensing medications.

For Anna Dimak, now a UWSOP PharmD student, participating in the 2017 STEP event proved to play a pivotal role in her decision to pursue a career in pharmacy.

“STEP was crucial for my pharmacy journey because it introduced me to the profession long before I stepped foot in a pharmacy,” she recalled. “I participated in hands-on activities that taught me more about the pharmacy profession than my hours of Internet research could. Having a low-stress environment to explore various aspects of pharmacy was a lot of fun for me back then and got me excited about pursuing it later. Not only that, but I got to meet people that are still my friends to this day!”

Dimak brought her STEP experience full circle this year, volunteering as an assistant for the event.

“I’ve always enjoyed sharing the exciting bits of my education with those who are a little less familiar with the subject, so this was an amazing opportunity,” she said. “When we made a gel in the Department of Pharmaceutics this year, I remembered making a gel during STEP in 2017. I thought about this while teaching the high schoolers about capsules and wondered if they would experience the same feeling when they take a pharmaceutics course and make capsules again.”

According to Dimak, one of the program’s greatest strengths is that the UWSOP provides a safe, stress-free environment for young students to explore the pharmacy profession.

“I feel like students can really get a good sense of the depth of pharmacy while having lots of fun and meeting great people,” she noted. “Even if students don’t continue on to practice pharmacy, one of STEP’s strengths is it teaches them how to appreciate what pharmacists do.”

Although pharmacy is the emphasis for STEP, students are also exposed to other careers in health care through visits to the UW Nursing Simulation Lab, interacting with representatives from other UW health science programs and taking a virtual tour through the UW Medical Center Pharmacy.

For more information about STEP, visit: https://sop.washington.edu/pharmd/admissions/step-summer-program/

Study Examines Effects of Regulations That Eliminate Insurance Cost-Sharing for Colorectal Cancer Screening

JAMA Network Open has published a new study – “Comparison of Screening Colonoscopy Rates After Positive Noninvasive Testing for Colorectal Cancer in States With and Without Cost-Sharing”– examining the effects of policies in Oregon and Kentucky that eliminate insurance cost-sharing for colorectal cancer screening procedures.

Authored by Douglas Barthold, PhD; Kai Yeung, PharmD, PhD; David Lieberman, MD; and A. Mark Fendrick, MD, the article reveals that, the elimination of cost sharing for the entire colorectal cancer screening process increased screening uptake in Oregon, but not in Kentucky. “The removal of out-of-pocket costs is an important step to enhance screening uptake,” said lead author Douglas Barthold, PhD, Research Assistant Professor in University of Washington’s Department of Pharmacy and Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, “but additional elements such as access to care, health literacy, and transportation also influence screening rates.”

Importantly, the study introduces key findings that will inform an active policy debate on whether these regulations will be extended to the Medicare program. The findings from Oregon include a substantial shift in initial screening modality from colonoscopies (more expensive) to non-invasive testing (less expensive), leading to a lower cost-per-patient screened.

“The main goal of colorectal cancer screening is to identify those people who could benefit from early detection,” said co-author A. Mark Fendrick, MD, Director of the Center for Value-Based Insurance Design at the University of Michigan. “These findings suggest that the removal of financial barriers for the entire colorectal cancer screening process will lead to improved patient centered outcomes, enhanced equity and lower healthcare expenditures.”

Four students awarded Baxter scholarships in Geriatric Pharmacy

Four second-year pharmacy students have been selected to receive a Baxter Scholarship toward their fee for the Plein Certificate in Geriatric Pharmacy. The Plein Center Leadership Team was inspired by the motivation and vision of the scholarship recipients. Each scholarship winner shared compelling personal stories of experiences that inspired them to pursue a career in geriatric pharmacy. A link between all of them is a desire to strengthen relationships with – and uphold dignity and agency to – older adults.

SOP Receives Gift From Washington Research Foundation For BRAMS Program

The SOP recently received a $75,000 gift from the Washington Research Foundation (WRF) to establish the Regulatory Sciences Fellowship Program, a new component of the School’s Biomedical Regulatory Affairs Master of Science (BRAMS) program. The gift will support 6 student stipends and their respective practicum projects, UW practicum faculty member support, and regulatory experts as preceptors of the Fellows.

“The BRAMS program at the UW School of Pharmacy is training the next generation of regulatory leaders and we are excited to support it,” said Will Canestaro, ’16, WRF’s managing director. “We believe that the Regulatory Sciences Fellowship will provide students with a meaningful project to help a researcher under the guidance of an experienced regulatory professional.”

“The practicum is the centerpiece of the BRAMS program whereby students conduct their projects with a life science organization, guided by preceptors and our talented faculty,” added Andy Stergachis, Professor of Pharmacy and Global Health and Director of the BRAMS program. “Thanks to this generous gift from WRF, the UW can expand practicum opportunities and continue to provide outstanding experiences with real-world regulatory activities for our students.”

Manisha Ramaseshan is a second-year student pursuing her MS degree in the program, and her practicum was supported through an earlier gift to the UW from WRF. She decided to apply to the BRAMS program because it provides a unique combination of academic and practical training, exposing students to both regulatory affairs and clinical research.

“I come from a life sciences research background and was looking for an ideal career path that could help me support medical product development while utilizing my communication skills,” she said. “I felt biomedical regulatory affairs would be a great way to understand the ‘micro’ and the ‘macro’ aspects of medical product development.”

Manisha added that BRAMS affords a holistic experience, covering academic knowledge, practical knowledge, and regulatory communications. These aspects have helped her pick up new – and further develop existing – skills.

“Breaking into any new industry can be an uphill task and the BRAMS experience has equipped me with foundational knowledge and key skills that has helped me better prepare for the professional roles I intend to pursue,” she added. “The BRAMS program has also given me an opportunity to meet and interact with industry experts, alumni, and cohort members who come from diverse backgrounds.

“Their experiences and interactions have been valuable in shaping my thinking and perspective towards becoming a regulatory affairs professional.”

For more information on BRAMS, visit: https://www.regulatoryaffairs.uw.edu/

Steve White receives achievement award from AES

UWSOP Professor and Chair of the Department of Pharmacy H. Steve White has been honored with the Extraordinary Contributions to the Field of Epilepsy Award by the American Epilepsy Society (AES). The award was announced this week at the 2020 AES Annual Event.

The Extraordinary Contributions to the Field of Epilepsy Award is designated for those who have made exemplary contributions across multiple fronts, including science, education, leadership and advocacy. The award is only presented when the AES Board of Directors determines there is a candidate whose accomplishments embody the spirit of the recognition.

“I am truly honored and humbled by this award,” said White. “To echo the 17^th-century poet John Donne, ‘No man (or person) is an island’. With this in mind, I largely owe any success that I have achieved over my career to the partnerships I have enjoyed since my early days as a graduate student.”

Over the past four decades, White has devoted his career to epilepsy research, with a focus on understanding what causes seizures and ways to mitigate them. He has been the recipient of significant research funding from the National Institute of Neurological Disorders and Stroke (NINDS), and the National Institutes of Health (NIH). White and his collaborators have published more than 170 original papers pertaining to the mechanism of action and the pharmacology of antiepileptic drugs. In addition to his academic service, he served as Research Director of CURE (Citizen’s United for Research in Epilepsy), the largest non-governmental provider of epilepsy research funding, from November 2011 until October of 2015, where he assisted in the development of strategic programs that advance transformative epilepsy research that may someday lead to a cure, or disease modifying therapy, for the patient at risk for developing epilepsy.

In addition to his extraordinary work as an educator and researcher, Steve and his wife Kathryn created an endowed scholarship fund to provide financial support to students at the UW School of Pharmacy with an interest in epilepsy research. Learn more about the Epilepsy Education and Research Endowed Pharmacy Scholarship Fund.

UWSOP grad students represent state in national ASHP competition

Congratulations to Camille Troyer and Jessica Bixby, who will be representing the state of Washington December 5 & 6 in the national American Society of Health-System Pharmacists Clinical Skills Competition.

The CSC, an interactive, team-based analysis of clinical scenarios for hospital and health-system pharmacists, provides PY2, PY3 and PY4 pharmacy students the opportunity to enhance their skills in collaborative practice with physicians in providing direct patient care. Comprised of pharmacy teams representing schools all over the country, the competition will be showcased this weekend during the ASHP’s annual December Mid-Year Clinical Meeting.

UWSOP Professor of Pharmacy Doug Black (along with fellow Professor of Pharmacy Lingtak-Neander Chan) has served as a local ASHP judge and mentor for nearly two decades, and the local competition this year hosted a record turnout with 46 teams and a total of 92 students participating – nearly a quarter of the SOP student body.

Doug notes a couple of contributing factors regarding this year’s increased participation.

“The student leaders who put this together do a really good job of promotion,” he said. “And I also think our students understand that the work they do here helps when they apply for residencies or jobs. It’s a recognized accomplishment they can put on their resume.”

Though Camille Troyer and Jessica Bixby emerged victorious and will represent UWSOP in the upcoming national competition, Doug and his colleagues have a lot of appreciation for all students who work so hard to prepare and compete in the event, as they take time out of an already-packed schedule of classroom and research lab work, year after year.

“It takes a lot of courage on the students’ part to jump into this thing, particularly as PY2 students,” he said. “These cases are difficult, and only the PY4s have completed their therapeutics – yet they all jump in and give it their best. I admire them for that.”

Though it would be nice to win the competition this year (the School’s last national victory was in 2011), Doug says the true reward is watching students and teams grow year after year.

“For me, as a professor, watching them get better over four years is just great evidence that people really do learn here,” he said. “For Lingtak and I, to see them evolve is really gratifying. I wish all faculty could see that – it makes you feel good about what you do.”

For more information on the event:

https://www.ashp.org/About-ASHP/Awards/Student-Awards/ASHP-Clinical-Skills-Competition?loginreturnUrl=SSOCheckOnly

Promoted UWSOP faculty tackling tough problems facing population health with novel approaches

Recently promoted faculty are finding news ways to solve significant population health problems from Alzheimer’s and related dementias to kidney disease to cancer to MRSA. These preeminent researchers were all recently awarded promotions. Learn more about their research and read stories about their innovative research below.

Abhinav Nath, PhD, Associate Professor, Department of Medicinal Chemistry

Abhi and his group are developing new and powerful methods to characterize and control protein dynamics, building on recent advances in biophysics, biochemistry and pharmacology from groups around the world. They focus on proteins involved in degenerative disorders (such as Alzheimer’s disease), the oxidative stress response, and drug metabolism. Read more.

Ed Kelly spoke at NASA a few days before the launch happened, explaining why the team is sending Kidney on a Chip to the International Space Station.

Ed Kelly, PhD, Department of Pharmaceutics Associate Professor, awarded tenure

In the broadest sense, the Kelly lab research interests are within the realm of preclinical biology. In particular, we are interested in applying novel technology platforms to address the 3 Rs of toxicology in animal testing, reduce, refine and replace. Active areas of research in the Kelly lab focus on ex vivo modeling of human organ physiology and toxicological responses to drug/xenobiotic challenge. These project makes use of “organs on chips” or microphysiological systems (MPS) populated with primary and stem-cell derived cell types to recapitulate two key ADME organs, the liver and kidney as alternatives to preclinical animal toxicology studies. Recent work is extending MPS technologies to model select human diseases as well as how organs respond to the extreme environment of microgravity on the International Space Station. Read more about Kidney Chips in space.

Assitant Professor Aasthaa Bansal’s team will look at care for colorectal cancer, prostate cancer, and chronic myeloid leukemia. Their approach will extend to other diseases, including pediatric cancers.

Aasthaa Bansal, PhD, Associate Professor, Department of Pharmacy

Aasthaa’s research focuses on sequential decision-making using longitudinal data, prediction modeling, decision theoretic methods including value of information analysis, and comparative effectiveness and outcomes research using large healthcare claims databases and EHR data. She is the PI of a study to develop methods for cost-effective personalized risk-adaptive surveillance in cancer and leads the team of investigators that received a prestigious NIH MERIT Award. Read more.

Brian Werth, PharmD, Associate Professor, Department of Pharmacy

Brian’sresearch interest is in antimicrobial resistance and the pharmacokinetics and pharmacodynamics of antimicrobials. His interdisciplinary translational research program is primarily focused on understanding the mechanisms of cross-resistance among glycopeptides, lipopeptides, and lipoglycopeptides in Methicillin-Resistant Staphylococcus aureus (MRSA). Read more.

Cathy Yeung, PharmD, PhD, Assistant Professor, Department of Pharmacy

Cathy’s research includes both basic science and translational studies, and spans from the determination of molecular mechanisms of altered drug metabolism using 3-dimensional cell culture techniques to the evaluation of the effect of drugs and nutritional supplements on health outcomes in patients receiving hemodialysis. She is a key investigator in the development of a “kidney on a chip” microphysiological system that can be used in preclinical drug development. Read more about Kidney Chips in space.

Congratulations to all!

To study with researchers like these, click on the links for more information about our Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.

Want to earn your PharmD professional degree at the UW? Start here to learn more.

Using Data and Economics to Transform Health | Celebrating 25 Years

CHOICE faculty and students at the 2019 retreat

Celebrating 25 years, The CHOICE Institute continues to grow and transform, expanding its impact on population health.

“At CHOICE, we work to advance the study of health economics, pharmaceutical outcomes research, and policy to improve population health in the U.S. and around the world.”—Anirban Basu, Stergachis Endowed Director, Choice Institute

The Comparative Health Outcomes, Policy & Economics (CHOICE) Institute at UWSOP began largely out of a response to a student and workforce needs. In 1989, Andy Stergachis, now Associate Dean at UWSOP, was advising David H. Smith, ’90, ’98, who wanted to earn a PhD studying the impact of healthcare policies on population health.

At that time UW did not offer a Pharmacy PhD, so David created his own interdisciplinary program of study. Andy and Dean Milo Gibaldi, decided to create a doctoral program in Pharmacy. In 1990, Andy was awarded the Burroughs Wellcome/American College of Preventive Medicine Scholar in Pharmacoepidemiology Award, which provided much-needed seed funding for the program, including support for visiting faculty, such as epidemiologist Jackie Gardner, PhD, and a newly-minted PhD from UC Berkeley named Sean D. Sullivan.

When Sean and Andy first met, Sean was looking forward to his new position at Wolfson College at Oxford University. But fate (and Andy) had a different plan. Andy presented Sean with the vision of a world-class program in pharmaceutical outcomes research. Sean was intrigued. When Andy showed up—in person—at Berkeley a few weeks later, Sean said yes to Andy and then, “I had to write the most difficult letter of my professional career. After all, who says ‘no’ to Oxford? But it changed my life.”

Sean and Jackie joined the faculty team with Dale Christensen and Bill Fassett, ’69. The development of the new Pharmacy PhD program began in earnest. About 25 years ago, the team had attracted top scholars and built enough support to be officially designated the Pharmaceutical Outcomes Research and Policy Program (PORPP) at the UW.

In 2014, Sean became Dean of UWSOP, which meant finding a new Director, now named the Stergachis Family Endowed Director, thanks to a generous gift from Andy and JoAnn Stergachis. Anirban Basu, Ph.D, was selected and in 2017, he announced the launch of The Comparative Health Outcomes, Policy & Economics (CHOICE) Institute, an expansion of PORPP that organizes research and training activities and resources in the fields of health economics, policy analysis/big data sciences, economics of precision medicine, drug and vaccine safety, and global medicines issues.

CHOICE continues to thrive with world-class researchers and leaders in health economics like Professor Emeritus Lou Garrison, Professor Dave Veenstra, Professor Beth Devine, Associate Professor Josh Carlson, Associate Professor Aasthaa Bansal, who earned a prestigious 7-year NIH MERIT Award, 2011 PAA Distinguished Alumni Award recipient Ryan Hansen, ’03, ’12, Research Assistant Professor Doug Barthold, Shelly Gray and Zach Marcum from the UW Plein Center, and many more affiliates and leaders in outcomes and health economics research.

CHOICE Alumni have become leaders in academia, industry, and government, such as Jonathan Watanabe, ’98, ’08, ’12, faculty member at UC San Diego and the first pharmacist named to the National Academy of Medicine Emerging Leaders in Health and Medicine Scholars Program, and Mitch Higashi, ’01, who established the Health Tech Fund, and now is an industry leader.

To study with UWSOP’s top faculty in health economics and outcomes, medicinal chemistry, and pharmaceutics, click here for more information about our Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.

Want to earn your PharmD professional degree at the UW? Start here to learn more.

A Tradition of Reinventing Pharmacy

UW School of Pharmacy Research Assistant Professor Ryan Hansen, PhD, PharmD — UW School of Pharmacy Assistant Professor Ryan Hansen, PhD, PharmD, and principal/Chief Technology Officer at Kelley-Ross Pharmacy.

Never doubt the profound impact that our faculty and alumni have had on health care nationwide through decades of advocacy for increased access to patient care.

“Pharmacists are the medication experts on the health care team and in the community. Thanks to our work, in addition to improved care at hospitals and clinics, busy people can just pop into their local pharmacy to get the care they need.”—Don Downing, ’75, I2P2 Endowed Clinical Associate Professor

Increasingly, deadly illnesses are becoming chronic illnesses thanks to advances in drug development and improved medical care. This change calls for increased interprofessional expertise on the health care team—which is where pharmacists come in.

The movement to increase the role of the pharmacist on the health care team began in earnest forty years ago. In 1979 Washington became one of the first states in the country to enact legislation to allow pharmacists to participate in collaborative drug therapy agreements (CDTA) with physicians. UWSOP alumnus Tim Fuller, ’69, was instrumental in the process to create these agreements.

As noted in Sean D. Sullivan’s article, “Pharmacists as health care providers” in the Journal of the American College of Clinical Pharmacy, “In addition to granting pharmacists dependent prescriptive authority, the revised Practice Act allowed for the direct administration of drugs, drug use monitoring and management, and the ability of pharmacists to order, review, and use laboratory tests to modify drug therapy.” Most importantly, these services were extended to all licensed pharmacists in the state, as long as they had a CDTA.

The 1990s saw big changes in pharmacy practice in Washington state. Recognizing that pharmacists were both underutilized and the most accessible health care providers, Jackie Gardner and Don Downing, ’75, worked together to expand what a pharmacist could do. They began with advocating for and training pharmacists to administer vaccinations—now a nationwide and growing global practice.

Don and Jackie went on from that success to develop the nation’s first pharmacist-provided emergency contraception program and the first pharmacist-initiated ongoing hormonal contraception services. In 1995, the “Every Category of Health Care Provider Law,” was passed, stating that private insurance companies could not exclude licensed providers from their networks, so long as the services provided were within the scope of their license. Initially not considered eligible under this Act, Don advocated for pharmacist inclusion. In 2013, he petitioned the Washington State Insurance Commissioner and the Attorney General to issue legal opinions that Pharmacists had to be included. He followed those supportive opinions with advocating for legislation that required insurers to compensate pharmacists for their clinical work, not just drug dispensing.

That legislation passed successfully in 2015.

The increased access to care provided by pharmacists has been supported by the alumni-supported Institute for Innovation in Pharmacy Practice (I2P2) Endowment.

Jackie Gardner | Epidemiologist & Legendary Advocate for Increased Access to Care

Jackie was co-director of the Retail Pharmacy Management Program and led the Institute for Innovation in Pharmacy Practice (I2P2)—the I2P2 fund was later named after her—in addition to being an early PORPP faculty member. She worked as a pharmacy technician, which inspired her strong advocacy for expanding pharmacy services to include immunization, contraception, and other value-added care. “Jackie changed the profession of pharmacy and the way individual pharmacists embraced patient care,” said Don Downing.

Tim Fuller, ’69 | Father Of Pharmacist Collaborative Drug Therapy

Tim was instrumental in the process to create collaborative drug therapy agreements. He began with a study of the 60 prescriptive authority protocols that were filed in the Board of Pharmacy office, showing an overwhelmingly positive response by physicians and pharmacists to pharmacists prescribing in collaboration with physicians. He worked with pharmacists to expand this practice. His book, The Handbook of Collaborative Drug Therapy, provided templates for pharmacists to use. He is the 2018 PAA Distinguished Alum.

Don Downing, ’75 | Advocate for Pharmacy and Women’s Reproductive Health

After graduating from UWSOP, Don was asked by the Puyallup Tribe to help them open up a tribal health clinic – a clinic where he remained for the next 10 years. He developed the nation’s first pharmacist-provided emergency contraception program and the first pharmacist-initiated ongoing hormonal contraception services. He also helped lead the effort in the 1990s to educate and certify pharmacists in Washington state and numerous other states to provide flu shots and other vaccines.

Jennifer Bacci | Assistant Professor & Community Pharmacy Researcher

Jennifer’s primary research interest focuses on the application of implementation science to evaluate and advance the adoption and reach of innovative patient care models in community pharmacy practice, including being co-investigator on PROJECT VACCINATE with Peggy Odegard. The team saw a 14% increase in the number of influenza, pneumococcal, herpes zoster, and pertussis vaccinations in just one year as a direct result of their work, which was supported by the Centers for Disease Control and Prevention (CDC) and National Association of Chain Drug Stores (NACDS).

Want to earn your PharmD professional degree at the UW? Start here to learn more.

Enhancing the way epilepsy is managed by engaging community pharmacists

Community pharmacists can play a key role in managing care for people living with epilepsy.Mike Mozart/Flickr

The University of Washington’s School of Pharmacy today announced a collaboration with global biopharmaceutical company UCB to improve access to care for people living with epilepsy.This interdisciplinary project will explore ways in which community pharmacists can better support people living with this neurological disorder.

The roughly 3.4 million people nationally and 75,000 people in Washington state who live with epilepsy often get fragmented and uncoordinated healthcare and community services.

Co-investigator H. Steve White, Professor & Chair, UWSOP Dept of Pharmacy

“For the growing population of people living with epilepsy, this fragmentation of resources makes it harder to manage multiple co-existing health conditions and take anti-seizure drugs,” said Steve White, professor and chair of the UW department of pharmacy, and a global expert on epilepsy. “And given the importance of medication adherence to manage epilepsy, poor adherence can have profound effects including injury, hospitalization, even unexpected death.”

The project isled by White; Jennifer Bacci, Assistant Professor, Department of Pharmacy; Andy Stergachis, Associate Dean for Research, UW School of Pharmacy; and Sabra Zarâa, CHOICE Institute PhD student and builds upon the funding grant from the UW Population Health Initiative announced earlier this year.

Epilepsy is a complex and devastating disease in which patients experience spontaneous and recurrent seizures. This condition can impair daily routines, such as driving and working, which can often result in substantial socioeconomic disparities. Medications to treat the condition can be associated with serious side effects, and the seizures themselves can lead to on-going health challenges.

Co-Principle Investigator and Assistant Professor Jennifer Bacci

“Community pharmacists are among the most accessible healthcare providers for many in Washington state, and have extensive knowledge of drug therapy as well as the ability to support people in managing complex medication regimens, yet are seldom leveraged to close the gaps in epilepsy care,” said Jennifer Bacci, assistant professor at UW School of Pharmacy. Moreover, “community pharmacists educate patients about their disease, ensure dosing accuracy, monitor for side effects and drug interactions, and encourage medication adherence.”

At a population level, community pharmacists collaborate with other healthcare providers and assess medication use patterns and patient outcomes data to ensure medications are used effectively, safely and in a cost-effective manner. No models exist for engaging community pharmacists in population health approaches to epilepsy care.

“The UW Population Health Initiative seeks to accelerate new collaborations between diverse disciplines to find innovative solutions to the complex challenges society faces,” said Ali Mokdad, the UW’s chief strategy officer for Population Health and professor of Health Metrics Sciences. “We are excited to support the UW and UCB in bringing together the expertise and resources of the public and private sectors to develop a novel approach to increasing access to care for people living with epilepsy.”

The team will develop an intervention by conducting a needs assessment, including interviewing stakeholders and performing a literature review. They will (1) identify best practices to address the needs of persons living with epilepsy and their caregivers; (2) develop a community pharmacy intervention using a stakeholder driven and consensus building approach; and (3) evaluate the acceptability, appropriateness, feasibility and potential effectiveness of the intervention.

“Community pharmacists are increasingly at the front line of healthcare delivery in the US.” Said Mike Davis, Head of U.S. Neurology at UCB. “With these tools to facilitate better conversations with their community living with epilepsy they can play an important role in ensuring that more people living with epilepsy get to the right treatment at the right time. The University of Washington is doing great work in this area and UCB is proud to collaborate with them on this initiative.”

Project Team
Jennifer Bacci, UW Assistant Professor, Department of Pharmacy
H. Steve White, UW Professor and Chair, Department of Pharmacy
Andy Stergachis, UW Professor and Associate Dean for Research, Graduate Programs and New Initiatives
Sabra Zarâa, The CHOICE Institute at UW School of Pharmacy, PhD student
John Miller, UW Medicine, Neurology
Edward Novotny, UW Medicine, Neurology and Seattle Children’s Hospital
Bryan Weiner, UW, Departments of Global Health and Health Services

Matt Schumacher, UCB, Head Neurology Healthcare Strategy

Lawford Ricafort, UCB, Neurology Ecosystem Lead – Pacific West

Grant Simic, UCB, Population Health Partner

For more information, contact Jake Ellison at University of Washington News at jbe3@uw.eduor 206-543-2580, or Allyson Funk at UCB at uscommunications@ucb.com.

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About UW School of Pharmacy:
Ranked in the top 4 in the world for pharmacy and pharmaceutical sciences research, the UW School of Pharmacy is comprised of three departments: Medicinal Chemistry, Pharmaceutics, and Pharmacy, offering Ph.D., M.S., and PharmD degrees, post docs and certificate programs. The UW School of Pharmacy is a global leader in pharmacy education, research and service, committed to providing a transformative learning experience in a collaborative and diverse environment focused on improving the health and well-being of the communities we serve.

About UCB
At UCB, we come together every day to work, laser-focused, on a simple question: How will this create value for people living with severe diseases? Patient value is not just what we say, but how we how we live. It is our culture of care, embodied by our patient value strategy. That’s because how we do business – from discovery to development to delivery – has been transformed and redesigned around the patient and their individual experience. Patients are at the heart of everything we do, inspiring us, driving our scientiﬁc discovery, and leading us to rethink the patient experience. By fulﬁlling our commitment, driving innovation, and providing patients a meaningful experience, more impactful solutions are on the horizon.

With a team of approximately 7,500 employees and operations in approximately 40 countries, we are a global biopharmaceutical company investing more than a quarter of our revenue in cutting-edge scientific research to meet unmet patient needs. Global headquarters are in Brussels, Belgium, with U.S. headquarters in Atlanta, Georgia. Additional U.S. UCB sites include global clinical development in Raleigh, North Carolina, research supporting UCB’s pipeline in Boston, Massachusetts and Seattle, Washington, and offices in Washington, D.C., Durham, North Carolina as part of our acquisition of Element Genomics.

The Future of Pharmacy

Celebrating 125 Years of Impact & Innovation

Our mission is to develop exceptional pharmacy leaders and researchers, discover solutions to improve population health, and serve the health and well-being of the public, locally and globally…even in space.

“We aren’t waiting for the future to happen. We are proactively accounting for what these changes mean and preparing our student pharmacists and researchers to think critically and be able to adapt to whatever policies, innovations, or technologies are to come.”.—Sean D. Sullivan, Professor and Dean, UW School of Pharmacy

At the University of Washington School of Pharmacy, we embrace diverse perspectives, beliefs and cultures and work to serve the greater good of society.

When pharmacists are open and educated on how to support their patients, the quality of care improves. Through our training, research, and outreach, we make sure we are taking care of people–whatever their needs are. Our work matters and we make a difference.

In 2009, then student, now alumna, Joanna Preker, ’12, worked with I2P2 Endowed Clinical Professor Don Downing, ’75, to advocate for improved patient access to sexual and reproductive health services. Founded and named by Joanna, Pharmacy for Reproductive Education and Sexual Health (PhRESH) was a first-of-its-kind pharmacy student organization. Her novel efforts were successful, resulting in increased access to health care for women and families in Washington and elsewhere.

Sam Miller and his poster presentation at the 2019 AACP Conference

Sam Miller, PharmD candidate, class of 2020, an active PhRESH member, is leading the way in supporting transgender patients. He has created a toolkit and resources to train pharmacists in how to communicate they are a welcoming pharmacy—from asking for preferred pronouns to wearing pronoun buttons on lab coats. Sam’s programs include the technical aspects of supporting transgender patients including training them on injecting hormones, helping with insurance coverage questions, and more. Sam won an award at the WSPA Northwest Pharmacy Conference for his research poster on training pharmacists to support transgender patients and recently did a rotation at the Human Rights Campaign.

The team reconvened Saturday, May the 4th, 2019...ever hopeful that this time the launch would be successful. — The team reconvened Saturday, May the 4th, 2019…ever hopeful that this time the launch would be successful.

We are boundless in our efforts to improve health care. In 2019, faculty members Ed Kelly, Cathy Yeung, ’05, ’13, and their team, along with collaborators at UW Medicine and Kidney Research Institute, watched live at Kennedy Space Center in Cape Canaveral as the Kidney on a Chip project launched to outer space. The project aims to help people on Earth and future astronauts on missions to Mars. One of the challenges of spending years in microgravity is that there is a high increase in kidney-related health problems, including osteoporosis and kidney stones. The team hopes to gain insight into that rapid aging process through the microphysiological chips.

Thanks to donors like Richard, ’54, and Susan Coar, we continue to support forward-looking research projects like those supported by UWSOP Faculty Innovation Awards. Pharmacy’s Brian Werth and Medicinal Chemistry’s Libin Xu received funds to support their novel research into antibiotic resistance mechanisms in the superbug, methicillin-resistant Staphylococcus aureus (MRSA), which has led to a $1.86M NIH grant.

Medicinal Chemistry Assistant Professor Libin Xu (left), Pharmacy Assistant Professor Brian Werth (right), are pictured in conversation with Medicinal Chemistry’s Senior Fellow, Kelly Hines (center). Their research earned them the inaugural award from the UWSOP Faculty Innovation Fund, which provides financial support for one to two awards of up to $20,000 each for high-risk, innovative research projects. — Medicinal Chemistry Assistant Professor Libin Xu (left), Pharmacy Assistant Professor Brian Werth (right), are pictured in conversation with Medicinal Chemistry’s Senior Fellow, Kelly Hines (center). Their research earned them the
inaugural award from the UWSOP Faculty Innovation Fund, which provides financial support for one to two awards of up to $20,000 each for high-risk, innovative research projects. Photo: Alex Levine

An interdisciplinary team led by CHOICE Professor Beth Devine, with Pharmaceutics’ Isabelle Ragueneau-Majlessi, ’10, and Pharmacy’s Shelly Gray and Jennifer Wilson Norton, ’93, earned the Faculty Innovation Award funds for their research on using pharmacogenetic testing on clinical outcomes in retirement communities. UWSOP’s Jennifer Bacci, and Basia Belza, from the UW School of Nursing, are serving as advisors. Abhi Nath is looking for new ways to predict how the body metabolizes biologics, also known as “large-molecule” drugs or protein-based therapeutics. These drugs display immense potential in the treatment of many challenging forms of cancer, autoimmune disorders, and infectious and degenerative diseases, but little is known about the factors that govern their pharmacokinetics and disposition. Professor Allan Rettie’s team seeking new personalized ways to slow the progression of the development of breast cancer by focusing in on an enzyme, CYP4Z1, that can go rogue, which may lead improved therapies that are custom for a patient’s particular type of breast cancer.

These interdisciplinary approaches to training are indicative of the multi-disciplinary approach to solving problems of population health. We are proud of the tradition of alumni who are both pharmacists and researchers, including Dave Veenstra, Beth Devine, Jean Dinh, ’05, ’09, ’14, Ryan Hansen,’03, ’12, Jonathan Watanabe, ’98, ’08, ’12, Cara McDermott, ’11, ’12, ’16, Cathy Yeung, Cate Lockhart, ’04, ’13, ’16, ’16, Todd Lee,’01, Kai Yeung, ’15, and Lindsay Henderson. The problems of health and the health care system are intertwined and complex. It will take leaders like our alumni to create a world where all people can live healthier and more fulfilling lives.

Advance your career as a pharmacist at the University of Washington. Learn more about our nationally and globally top-ranked PharmD Program.

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Supporting cancer survivors

Aasthaa Bansal leads an NIH MERIT award-winning team to develop decision-making frameworks to guide post-treatment care for cancer survivors

Assistant Professor Aasthaa Bansal’s team will look at care for colorectal cancer, prostate cancer, and chronic myeloid leukemia. Their approach will extend to other diseases, including pediatric cancers. Photo: Alex Levine

Despite receiving effective primary treatment, many cancer survivors remain at risk of relapse and associated morbidity and mortality. Surveillance testing using biomarkers and imaging may detect disease recurrence before clinical symptoms manifest and allow for early treatment.

Current guidelines recommend frequent testing in most cancer settings. However, frequent testing involves trade-offs. Many patients are at low risk of experiencing recurrence, and the complications and costs of frequent tests are not justified for these patients. Experts have cautioned against over-testing and advocated for risk-based strategies using the personal clinical history of each patient to provide better tailored care to cancer survivors. Although there is growing recognition that a one-size-fits-all strategy of frequent patient visits may be suboptimal, there is ambiguity regarding how best to tailor surveillance to individual cancer survivors.

“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.”—Assistant Professor Aasthaa Bansal, The CHOICE Institute

Assistant Professor 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. The decision-making framework will evaluate the value of future clinical information and guide patient-level decisions about the optimal frequency of surveillance testing, while taking into account a patient’s evolving risk of recurrence. “As a patient’s information changes, if they go from low to high risk, for example, their follow-up recommendations will also be updated in this dynamic decision-making framework,” said Aasthaa.

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 general methodology developed by the research team could be applied to any disease setting where ongoing surveillance is a major component of patient care. “We are creating an approach that we plan to extend to other diseases, including pediatric cancers, where similar open questions exist,” reflected Aasthaa.

The NIH deemed her project so significant, they granted the 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 investigators whose research competence and productivity are distinctly superior and who are highly likely to continue to perform in an outstanding manner, according to the NIH. In 2016 and 2017, only eight MERIT awards were granted each year across all of NIH.

The National Cancer Institute of the National Institutes of Health funded this R37 grant (1R37CA218413-01A1) for $2.2M.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy in The CHOICE Institute at UWSOP.

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But is it safe for my baby?

Mary Hebert and the Obstetric-fetal Pharmacology Research Unit (OPRU) team are exploring how to optimize care for pregnant and lactating women

Mary Hebert and research nurse Maggie Leahy, RN, meet with an expectant mother as part of their study. Photo: Sarah C.B. Guthrie

How do medications for high blood pressure, depression, and even cancer affect pregnant women and their babies? Mothers and health care providers face a daunting challenge of making health care decisions about these vital medications with limited data.

Mary Hebert knows this dilemma first hand. Years ago when she was pregnant, she was faced with a complicated pregnancy herself and was rather frustrated at the lack of data available on the medications she needed. “I thought by the time I was pregnant the second time, there would be more information. But there wasn’t,” she shared. Given her background as a clinical pharmacist and researcher focusing on medications used in the management of solid organ transplantation, Mary knew she had to do something. Years later, her work on the impact of medications on maternal, fetal and neonatal health continues through two Federal grants.

“A healthy pregnancy requires consideration of the mother, fetus, and neonate.”—Mary Hebert, Pharmacy Professor and Director, UW Obstetric-Fetal Pharmacology Research Unit (OPRU)

Mary and her OPRU team are looking at how and why one of the most important drug-metabolizing enzymes has much higher activity in pregnant women than in non-pregnant people. Understanding this phenomenon is critical for drug dosing during pregnancy and has implications for 15-20% of the drugs used clinically. For example, one expectant mother had an abnormal heart rhythm and fast heart rate before she was pregnant, which was managed by a medication that was eliminated from the body by this enzyme. Mary and her colleagues found that pregnancy made the activity of this enzyme extremely high. Consequently, when this woman became pregnant, again her heart rate went dangerously high requiring emergency hospitalization and incremental increases in the dosage to manage her heart condition. It worked and she delivered a healthy baby at term.

The team approach, including physicians who specialize in maternal and fetal medicine, nurses, social workers, nutritionists, and pharmacists like Mary, through their research and clinical activities makes a profound difference in the quality of patient care for women with complicated pregnancies. “We were the first to study a number of cancer medications during pregnancy to try to understand how dosing is impacted by pregnancy,” Mary said. “Although these pregnancies are considered at high risk for complications, these women delivered healthy infants.”

Mary was also invited to partner on a National Institute of Child Health and Human Development (NICHD) study exploring medications in breast milk and their effect on the nursing infant. Initially, they are looking at ten commonly used medications, including labetalol (high blood pressure), metformin (diabetes), and escitalopram (depression and anxiety).

It’s vital that women pursue answers for their medication questions when pregnant, rather than just discontinuing them. “It might surprise you that conditions such as depression are not just associated with issues related to maternal mental health, they are also associated with complications such as pre-term birth and low birth weight infants. Sudden discontinuation of chronic medications is often more dangerous than the potential adverse effects of continuing the medications throughout pregnancy. When considering any medication during pregnancy we need to weigh the risks and benefits taking into consideration the underlying condition. Ultimately our goal is to have healthy mothers and healthy babies.”

These two grants include a four-year National Institute of General Medicine Sciences (NIGMS) R01 grant (GM124264-02) was funded in 2017 for $2.3M. The second is a $79,000 sub-contract from Duke University for a National Institute of Child Health and Human Development (NICHD) grant funded in 2018; BMS01 contract number HHSN- 275201000003I.

Advance your career in pharmacy practice, scientific and outcomes research at the University of Washington School of Pharmacy. Learn more about our Graduate (PhD and MS) degree programs and click here for more information about the UW PharmD program.

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Kidney on a Chip has gone to outer space..and returned to Earth!

Ed Kelly spoke at NASA a few days before the launch happened, explaining why the team is sending Kidney on a Chip to the International Space Station.

What did it take to send delicate kidney cells into space to be studied by astronauts wearing big, clunky gloves who may, or may not, have a background in biochemistry? We popped into the lab to talk to Ed Kelly and Cathy Yeung to find out.

Dawg Scripts: Why did you put kidney cells on a chip?

Associate Professor Ed Kelly: As a Toxicologist, we talk about the “Three Rs” when it comes to our research: reduce, refine, and replace. That means we are looking for ways to reduce animal testing, refine processes, and—where we can—replace animal testing. With Kidney on a Chip, we have a better model than testing kidney cells on plates under the microscope, in petri dishes, or with animals. The tubules—about the size of a human hair—housing the cells in the chip mirror the tubules in the kidney in the body and, like the kidney in the body, we can move fluid through the tubules and have more information than we would otherwise. For example, we did some testing using a powerful antibiotic. We knew the antibiotic was toxic but we didn’t know why. By using Kidney on a Chip, we were able to identify the biomarkers of toxicity, showing that the antibiotic was indeed toxic to renal tubular cells.

“We are planning for failure, even though that’s not an option.”—Ed Kelly, Associate Professor of Pharmaceutics

DS: So then why send chips to space?

Research Assistant Professor Cathy Yeung, ’05: Kidney disease can take years to develop. Microgravity accelerates kidney disease or dysfunction, and other conditions in astronauts, so the goal is to see the impact low gravity will have on the cells in the microphysiological chips. We anticipate learning more about how kidney stones, osteoporosis, and proteinuria (an abnormally high amount of protein in urine which indicates kidney damage) begins and develops. There aren’t many effective treatments for kidney stones currently. Last year, the main “recommendation” for treatment was to ride a roller coaster in hopes of dislodging the stone (we don’t recommend this course of treatment). Instead, we hope to gain some insights into how they develop that may lead to improved therapies.

DS: What can you tell us about the cell samples you are using?

CY: The kidney cells used come from two men and two women so we will be able to see gender differences, which is important for diseases like osteoporosis which has a higher incidence among women. All of this research is important for people on Earth, as well as the future of missions to Mars when people will be in microgravity for years. We have questions about how kidneys process Vitamin D and hope to gain insight about osteoporosis and how to prevent it from this research.

Cathy Yeung and Ed Kelly were asked when the launch would happen after the third launch delay. They responded in a precise scientific way. — Cathy Yeung and Ed Kelly were asked when the launch would happen after the third launch delay. They responded in a precise and scientific way.

DS: What are some of the challenges of sending the chips to space?

EK: We’ve had a lot of logistical challenges. First of all, we have to make the level of science very easy for
astronauts who will be working with large gloves. Some of the astronauts have advanced degrees in science, but we had to make sure that whoever is running the experiment that day could do the work needed. Another challenge was taking the 50 cubic feet of space we use to run the experiments in our lab down to a box about the size of a microwave to fit in the rocket and space station, which is why we partnered with BioServe Space Technologies at University of Colorado Boulder.

DS: Will there be a lab in space?

Very early Friday morning May 3, 2019, the team gathered to watch the launch...which was scrubbed 15 minutes before go time. It was rescheduled for very early in the morning Saturday, May the 4th. — Very early Friday morning May 3, 2019, the team gathered to watch the launch…which was scrubbed 15 minutes before go time. It was rescheduled for very early in the morning Saturday, May the 4th.

CY: There will be experiments running at precisely the same time on the ground as in the Space Station while the Chips are in space. Our team of faculty and graduate students will be on site at Kennedy Space Center in Florida running the experiments on Earth. So we have to create labs that will go to space and also recreate our lab in Florida. The box going to space with the chips has to be specially designed to handle the stressors of coming in and out of atmosphere, the vibrations in breaking the sound barrier, and dropping to Earth on its return. The kidney cells have to be kept at a constant 37 degree C temperature, which requires three different power sources from the time the chips are built on the lab on Earth, transferred to the rocket, and launched into space. We don’t know what will happen and we are doing our best, working with our BioServe partners, to anticipate as many obstacles as possible.

DS: What’s special about this project?

EK: We are proud that the University of Washington is the only university with two projects launching to the International Space Station as part of this nationwide Organ on a Chip project funded by the NIH and CASIS. Our project will be the first to launch and the Heart on a Chip by Deok-Ho Kim in Bioengineering will be the second.

Below are scenes from the Launch that happened on May 4, 2019. May the Fourth Be With You, was the rally cry of the day after multiple delays.

To watch the launch video, click here for a link to the SpaceX YouTube page.

See NASA’s photos of the Kidney on a Chip experiment in space!

AND WE HAVE LIFT OFF!!! Photo: Sarah C.B. Guthrie/NASA TV

To study with researchers like Pharmaceutics’ Associate Professor Ed Kelly and Pharmacy’s Research Assistant Professor Cathy Yeung, click on the links for more information about our Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.

Link to Pharmaceutics archived news

5/3 UPDATE: 5/3 11:48 PM PDT launch for Kidney on a Chip project to the International Space Station!

Updated May 3, 11:29 am Pacific: NASA has pushed back the launch to Friday, May 3 at 11:48 PM Pacific time…weather dependent.

PHOTO DATE: July 06, 2018 LOCATION: Bldg. 2 Lobby SUBJECT: NIH Tissue Chip. PHOTOGRAPHER: Josh Valcarcel — *Photo credit: Josh Valcarcel* Photo: Josh Valcarcel

May 3 update:

Welp. It seemed like it was going to go and then about 15 minutes before launch, the flight was scrubbed. It’s rescheduled for tonight 11:48 PM Pacific Time. Here is an update on NASA’s blog.

May 2 update:

The International Space Station crew fixed the power problem and is ready to catch the SpaceX rocket. What we don’t know right now is if the weather with abide and allow for lift off at 12:11 am Pacific time. We will be live tweeting tonight with our fingers crossed. Follow here.

–End May 2 update

Want even more detail about the precautions being taken to ensure a successful mission? Get out your electrical engineering hat, and read more/view schematics here: “Electrical issue on Station delays Dragon launch”

The launch date may be subject to change, again. We will continue to update this page as we get more news!

A kidneys-on-a-chip experiment is being readied at Cape Canaveral, Florida, to fly aboard a SpaceX Dragon C19/Falcon 9 supply shuttle to the International Space Station. At an altitude of 250 miles, the chip technology will be used to study reduced gravity and other space flight conditions on kidney physiology.

The unmanned SpaceX mission CRS17, contracted with NASA, was slated for late April and is delayed until May 1. The launch date will not be official until after the Flight Readiness Review

Three other organs-on-chips will be on-board for studies of lung host defenses, the blood-brain barrier, and musculoskeletal diseases. Developed by research groups nationwide, the four projects are part of the Tissue Chips in Space program. This will be the second time that National Institute of Health tissue chips have been flown into space. The first study was on aging and the immune system.

The National Center for Advancing Translational Sciences at the National Institutes of Health spawned the creation of these small, bioengineered tissue chips, which model the physiology of human organs on a living, 3-D microscale. They have been developed to speed the search for new drugs and therapies and get these treatments to patients faster. Researchers use the tissue chip systems to study healthy and diseased states, and to test medications and other treatments.

Scientists at UW Medicine and the University of Washington School of Pharmacy, with collaborators in industry and other agencies, designed the kidney-on-a-chip component.

Pharmaceutics PhD student Kendan Jones-Isaac working on the Kidney on a Chip project in Ed Kelly's lab — Pharmaceutics PhD student Kendan Jones-Isaac working on the Kidney on a Chip project in Ed Kelly’s lab Photo: Alex Levine

Several of them are at Cape Canaveral now preparing the devices.

The credit-card size chips contain fluid microchambers lined with human-derived kidney cells. For this space mission, these chips will simulate one type of kidney tubule.

In actual kidneys, similar anatomical structures regulate absorption and release of substances in the blood, among them medications and toxins. Vitamin D metabolism, important for bone strength, takes place in kidneys. Kidneys also protect against fluid retention and other biochemical imbalances.

Aboard the International Space Station, where they will be exposed to microgravity for about two weeks, the organs-on-a-chip might reveal why kidney problems occur often and quickly among astronauts.

The chief scientists are Ed Kelly, associate professor of pharmaceutics, UW School of Pharmacy; Jonathan Himmelfarb, kidney disease specialist at UW Medicine and professor of medicine, Division of Nephrology, UW School of Medicine; and Cathy Yeung, research assistant professor of pharmacy.

They noted that this space study could provide insights into the development and overall health implications of kidney diseases on Earth, in less time than is possible with terrestrial research in humans.

The Tissue Chips in Space program findings may help protect astronaut health during longer space explorations. Photo: Alice Gray

Kidney disease occurs in about 10 percent of adults. Treatment can diminish quality of life. New tools, like the kidney chips, could help find ways to prevent or treat kidney problems in astronauts, as well as in people who will never venture into space.

“Certain conditions related to poor kidney health appear more rapidly in space and could have life-long consequences,” Himmelfarb said. These include protein in the urine, bone loss, and kidney stones.

“Aging of cells accelerates in space,” he added, indicating that organ-on-a-chip space research could uncover medical knowledge useful beyond a specific disease.

“We’ll be able to see in a matter of days what might take months on Earth,” the researchers said.

While microgravity alone might harm kidneys, the scientists also pointed out that astronauts are confined to a closed environment, are exposed to questionable chemicals, eat an unusual diet, and conserve and recycle water for drinking. Any of these could be rough on already vulnerable kidneys.

Research Assistant Professor Cathy Yeung (center) and the BioServe team work out how to pack an experiment for a space flight. Photo: Alex Levine

According to Kelly, the kidney-on-a-chip technology will evaluate how diminished gravity affects the ability of tubules, in both males and females, to conduct the basic work of kidneys. He explained that kidney cells sense gravitational forces in ways that direct the cells to carry out their activities.

“Kidney tubules are polarized,” explained Yeung, “and have an inside and outside. We are curious to see if the cells still stay polarized without Earth’s gravity, and what effect this might have on kidney cell function and on disease progression.“

The cells’ shape, spatial orientation and response to fluid flow could be disrupted in space. This distortion could alter how the cells that line the tubules transport water, electrolytes, vitamins and toxins, and could make tubules prone to damage from proteins or other biochemicals.

The researchers plan to send 24 Nortis Triplex Chips to the International Space Station in temperature and carbon dioxide pump assemblies.

While intergalactic space missions are still a stargazer's dream, kidney studies in Earth's orbit will likely make better treatment a reality on our planet. — While intergalactic space missions are still a stargazer’s dream, kidney studies in Earth’s orbit will likely make better treatment a reality on our planet. Photo: Alice C. Gray

After berthing, these will be placed in incubators and later put in a Life Sciences Glovebox. At the end of the experiment, they will be preserved and cooled to await transport back to Earth.

“We had to shrink the size of our usual equipment to fit the tight quarters of the space station,” Himmelfarb said. It was like shoehorning a refrigerator into a microwave oven, while maintaining proper environmental conditions for the experiment.

“We had to make some 270 modifications to fit the setting of the International Space Station,” the researchers explained. Precautions were taken to keep the chips from shattering and creating a free-floating fragment hazard.

“On Earth, studies can be repeated. On the ISS, we have only one shot to get this experiment right. It will be a tense time for us,” Himmelfarb said.

The set up took into account the realities of working in orbit. The astronauts will perform experiments while wearing cumbersome gloves and space suits. Miniaturization and automation, however, should simplify their tasks – and provide new ideas for making such experiments easier to perform on Earth.

“One of the cool things about being at Cape Canaveral is that we can watch the astronauts do the experiments in real time,” Himmelfarb said.

Meanwhile, in normal gravity on Earth, a UW team will conduct the same protocols on kidney chip cells from the same donors, to obtain comparative, control data.

This summer, a second tissue chip launch to the ISS will test potential drug therapies for the biological changes observed during this mission.

Future research, led by UW bioengineering associate professor Deok-Ho Kim, will send hearts-on-chips to the International Space Station. Those studies will look at the influence of extended periods in space on heart muscle contractions. Besides causing kidney changes, space flight reduces cardiovascular fitness.

The National Center for Advancing Translational Sciences at the National Institutes of Health and the International Space Station United States National Laboratory, are funding Tissue Chips in Space, in collaboration with the National Aeronautics and Space Administration.

Kim and Kelly are scientists at the UW Medicine Institute for Stem Cell and Regenerative Medicine Research. Kelly and Himmelfarb are investigators at the Kidney Research Institute, a collaboration of Northwest Kidney Centers and UW Medicine.

Kelly also admits he is a sci-fi space exploration nerd who has a Star Trek Next Generation Borg Cube in his office.

Learn more about the NIH’s NCATS Tissues in Space Program

https://ncats.nih.gov/research/research-activities/tissue-chip/projects/space

Additional information on the Space X cargo resupply mission flight 17 to the ISS, as well as information on its live webcasts and YouTube viewings is available at its website, www.spacex.com

NASA astronaut Jack Fischer tweeted this photograph from the International Space Station on June 3, 2017. Photo: NASA

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UWSOP team wins the AMCP 2019 National Pharmacy & Therapeutics (P&T) Competition

(Front Row) Hanna Kleiboeker, ‘20, Eunice Kim, ‘20, Michael Sporck, ‘20, and Erin Ichinotsubo, ‘21, won first place at the National AMCP P&T competition

Congratulations to our PharmD students, Michael Sporck, ‘20, Eunice Kim, ‘20, Hanna Kleiboeker, ‘20 and Erin Ichinotsubo, ‘21, who won first place at the highly competitive Academy of Managed Care Pharmacy (AMCP) Foundation 19^th Annual National Student Pharmacist Pharmacy & Therapeutics (P&T) Competition. The team’s advisors were UWSOP faculty David Veenstra and Pete Fullerton. John Watkins of Premera served as their external advisor.

“We are extraordinarily proud of Erin, Eunice, Hanna, and Michael for their win at this year’s National AMCP P&T competition. The National P&T is one of the toughest competitions student pharmacists can go through. After months of studying and hard work, the team emerged at the top of a record number of competitors. Congratulations to the team on their outstanding achievement and our thanks to their advisors, Dave, Pete, and John for supporting the team.”—Sean D. Sullivan, Professor and Dean, UWSOP

The Competition is an annual team event that provides an immersive experience in effective formulary review and management. The awards were presented March 28 at the AMCP Foundation Awards Ceremony, held during the AMCP Managed Care & Specialty Pharmacy Annual Meeting in San Diego, California.

This year the competition was exceptional with a record 67 schools of pharmacy nationwide participated in the Competition. Eight national finalists advanced to the live finals, where a panel of judges simulated a P&T Committee on March 26 at the AMCP Annual Meeting.

“The effort and energy invested by all of our competitors was evident in the depth of reasoning and professionalism displayed locally and at the national finals,” said Paula J. Eichenbrenner, MBA, CAE, AMCP Foundation Executive Director. “Competitors were supported in this rigorous journey by many dedicated faculty advisors, Competition coordinators, AMCP student chapter leaders, and volunteer judges.”

P&T Competition teams work through a case study using a product dossier in the AMCP Format for Formulary Submissions. Students evaluate the body of evidence on the study drug and comparators, assess value, and develop a monograph as they determine a recommendation for formulary placement and prepare an oral summary.

The study drug for the 2019 P&T Competition was TYMLOS® (abaloparatide) injection, indicated for the treatment of postmenopausal women with osteoporosis at high risk for fracture. The AMCP Foundation thanked manufacturer Radius Health, Inc., for facilitating use of this dossier and Dymaxium for hosting the Competition platform on AMCP eDossier.

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Click here for more information about our UW PharmD program.

Advice from UW pharmacists on senior use of marijuana

Marijuana use among older adults has soared in recent years despite little being known about the effectiveness and safety of the drug in people 65 and older. That’s resulted in more seniors asking health care providers about marijuana use: Is it safe? How much to use? Where to buy?

Now, a group of University of Washington professors has gone on the record to recommend ways to answer some of these questions and reduce the potential harm from marijuana use in this vulnerable population.

“Start low, go slow,” said Zach Marcum, assistant director of research for the Plein Center for Geriatric Pharmacy at the UW School of Pharmacy. He’s the lead author of a letter to the editor about marijuana use in older adults recently published in the Annals of Pharmacotherapy. “We discourage marijuana use, especially in the elderly. But we also acknowledge the reality that people, including seniors, are trying marijuana. If they’re going to use, use safely.”

Researchers realize that older adults are using weed, even to just try it out. If seniors are going to try marijuana, they should keep some basic safety guidelines in mind:

Buy from a reputable source and avoid buying marijuana products over the internet or on the street. Remember that even the most reputable-seeming retailers are selling an unregulated product that may or may not contain the exact amounts of the chemical compounds on the label.
Choose a product with a high CBD to THC ratio to limit the psychoactive effect. The experts recommend topical or transdermal preparation over anything that’s inhaled or eaten.
Start low and go slow. Use one-quarter to one-half of the recommended dose and monitor for potential adverse effects.

There are good reasons for older adults to worry about potential unforeseen consequences of using marijuana. Despite heavy marketing from the marijuana industry to older adults, this same group often is excluded from clinical research and trials. Changes to the body as one ages includes kidney and liver function that may alter the way the body reacts to the chemicals in weed. And little is known about how marijuana works with other medicines people might be taking.

While there’s much interest in marijuana use for a number of ailments, much more research is needed, Marcum said.

“There is still a need for quality studies regarding potential risks and benefits,” he writes in the journal.

Health care providers should ask their patients about marijuana use and employ risk reduction strategies, helping patients to make informed decisions. Pharmacists, Marcum notes, are uniquely positioned to engage older adults in these conversations as part of an overall medication management process.

Co-authors on the letter to the editor include Sarah Tu, and Dr. Lianne Hirano and Carol Crawford of UW Medicine.

Jackson Holtz

Learn more about cannabis use in older adults at out upcoming public lecture.
In Case You Missed It! Medications Update for 2019
Medication Headlines & Your Health
May 34, 2019 | 5:00 PM | Foege Auditorium, UW Seattle Campus
More information and registration online

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, Department of Pharmacy; H. Steve White, Professor and Chair, Department of Pharmacy; and Sabra Zarâa, CHOICE PhD student, Pharmacy on receiving one of the 2019 pilot research grants awarded by the UW Population Health Initiative. The interdisciplinary team’s project is titled, “Community pharmacist integrated population health management of people living with epilepsy.”

Epilepsy is a complex spectrum of seizure disorders, affecting approximately 3.4 million people nationally and 75,000 people in Washington state; and the number is increasing. It affects quality of life and leads to significant health and socioeconomic disparities. The experiences of a person with epilepsy involves managing multiple co-existing health conditions and taking anti-seizure drugs, the mainstay of treatment that are often accompanied by significant adverse effects. Yet, healthcare and community services are often fragmented and uncoordinated.

Community pharmacists are among the most accessible and trustworthy healthcare providers with extensive knowledge of drug therapy, yet are seldom leveraged to fill the gaps in epilepsy care or many other non-communicable diseases. Community pharmacists educate patients about their disease, ensure dosing accuracy, monitor for side effects and drug interactions, and encourage medication adherence. At a population level, community pharmacists collaborate with other healthcare providers and assess medication use patterns and patient outcomes data to ensure medications are used effectively, safely, and in a cost-effective manner. No models exist for engaging community pharmacists in population health approaches to epilepsy care.

This project seeks to develop a community pharmacist integrated population health intervention for people living with epilepsy by (1) identifying best practices to address the needs of persons living with epilepsy and their caregivers; (2) develop an intervention using a stakeholder driven and consensus building approach; and (3) evaluate the acceptability, appropriateness, and feasibility of the intervention. The intervention developed from this project will be piloted and evaluated for effectiveness in future research.

Investigators
Jennifer Bacci, Assistant Professor, Department of Pharmacy
H. Steve White, Professor and Chair, Department of Pharmacy
Sabra Zarâa, CHOICE PhD student, Pharmacy
John Miller, Neurology and Neurological Surgery
Edward Novotny, Pediatrics and Neurology
Bryan Weiner, Global Health and Health Services

Advance your career in pharmacy practice, scientific and outcomes research at the University of Washington School of Pharmacy. Learn more about our Graduate (PhD and MS) degree programs and click here for more information about the UW PharmD program.

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Werth and Xu awarded $1.86M NIH grant to continue MRSA investigation

Pharmacy’s Brian Werth and grant coinvestigator UWSOP Medicinal Chemistry’s Libin Xu will continue their novel research into antibiotic resistance mechanisms in the superbug, methicillin-resistant Staphylococcus aureus (MRSA). The team were recently awarded a 4-year, $1.86 million NIH R01 grant as principal investigator, which is an exceptional accomplishment for a young investigator.

With Libin’s expertise in ion mobility-mass spectrometry (IM-MS) analysis of lipids and Brian’s expertise in antibiotic resistance, they are working to understand the mechanisms of cross-resistance among antibiotics that target the bacterial cell membrane and cell wall.

This work could lead to the identification of novel targets for resistance-modifying therapeutics or more sensitive diagnostics to detect resistance.

In addition, the team received a UW Royalty Research Fund award of $38,175 for their project, “Targeting Altered Lipid Metabolism in Antiobiotic-Resistant Staphylococcus Aureus.” The RRF is funded from royalty and licensing fee income generated by the UW technology transfer program. The fund supports UW faculty seeking to advance new directions in research in disciplines for which external funding opportunities are minimal; for faculty who are junior in rank; and if the award might provide opportunities to increase applicants’ competitiveness for subsequent funding.

To read more about Brian’s collaboration with Libin Xu began with an outing to the College Inn Pub and a new UWSOP Faculty Innovation Grant, click here.

To study with researchers like Drs. Werth and Xu, click on the links for more information about our Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.

Leah Ruggerone and Richard Lee named to Husky 100

Leah Ruggerone, ’18, and PY3 student Richard Lee were both selected for the UW Husky 100 from the School of Pharmacy in 2018. Each year, the Husky 100 recognizes 100 UW undergrad and grad students who are making the most of their time at the UW.

Leah grew up in Kenmore, WA, and attended UW as an undergrad, majoring in biology and spent
summers working with fisherman in a small Alaskan town. The 12-14 hour days, 7-day workweek prepared her for a career in the health sciences: “I learned a lot about hard work and communicating with diverse people.” For Leah, Pharmacy brings together the chance to care for people and her love of chemistry. She’s worked as an Educational Assistant with PY1 pharmacy students, volunteered at Kiwanis Camp Casey for kids with physical disabilities, and served in several leadership roles at UWSOP. Her Advanced Pharmacy Practice Experience (APPE) rotations brought experiences working with HIV patients, NICU infants, and older adults at Era Living. She learned to understand how different patient populations may struggle with their medications. “My advice to other students is to really get involved and take part in as many outreach events as you can,” she shared.

Richard applied to be an undergrad at the UW by candle light and paper forms after a typhoon devastated his community on the island of Guam. He was interested in pharmacy to help support his father who is battling cancer. A UW Global Brigades trip to Panama in 2013 changed his life’s work. Serving as campus chairperson he leads multiple brigade teams annually. He realized people in developing countries couldn’t afford EpiPens and there is no 911 to call in remote towns. After vetting the idea of a low-cost autoinjector, he began the EpiForAll project, a low-cost EpiPen with UW Engineering colleagues. They have since won multiple business development awards, been issued a utility patent, and are expanding a patent portfolio. Richard shared, “My uncle pioneered liver transplant surgery, conducting the first German liver transplant in 1969. His accomplishments motivate me to have a wider impact on the world. My father’s service for those in need has driven me to helping the underserved, domestically and globally.”

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Devine and Chen debut Real-world Evidence Assessments and Needs Guidance (READi) Tool

CHOICE faculty member Beth Devine and CHOICE PhD student Shuxian Chen led an invited workshop last month at the Academy of Managed Care Pharmacy (AMCP) Nexus Meeting in Orlando Florida.

There, they presented their newly developed framework and tool that guides users in evaluating real world evidence (RWE) to inform health technology adoption decisions – the CHOICE “Real-world Evidence Assessments and Needs Guidance (REAdi) Tool.”

The tool integrates aspects of the formal systematic review process with concepts used in formulary decision-making. It is presented in REDCap, a secure web application widely used in academic settings for building and managing online surveys and databases. (https://www.project-redcap.org/) To guide each adoption decision, the user steps through three phases of evaluation using the tool. In Phase 1, the user defines the RWE question of interest by specifying the population, intervention, comparator, outcome(s), timing, and setting (PICOTS). The results are presented as a PubMed search query, with the user then executes to identify studies of interest. InPhase 2a, the user rates the quality of each identified study, using validated, publically available quality rating tools that are embedded in the web-based REAdi Tool. In Phase 2b, the user rates the strength of the body of evidence in support of each outcome. In Phase 3, using a checklist of practical questions (e.g. applicability, sufficiency, feasibility, affordability), the user is guided to the adoption decision. The tool-tasks conclude with a list of possible coverage approaches (e.g. prior authorization, guidelines, performance-based risk-sharing).

Shuxian Chen, PhD student at the CHOICE Institute

Joining Beth and Shuxian in creating the framework and tool were CHOICE faculty members Anirban Basu, Aasthaa Bansal, and Josh Carlson. Collaborating partners were Sophia Yun and John Watkins from Premera. Sophia Yun, ’15, and Jennifer Graff of the National Pharmaceutical Council joined Beth and Shuxian as presenters at Nexus. Graduate student, Jamie Ta, assisted in managing the breakout session where attendees practiced using the tool.

Feedback offered by attendees suggests the REAdi framework and tool will be useful in guiding payers in making formulary decisions. The tool is currently undergoing extensive user testing using timely and relevant drugs being considered for formulary adoption. The tool can be accessed here – check it out! https://sop.washington.edu/choice/research/research-projects/the-readi-tool/.

This work was supported through unrestricted funds from a consortium of twelve biomedical companies that are members of the School of Pharmacy’s Corporate Advisory Board.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

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CHOICE director Anirban Basu and collaborators receive NIH grant to study costs of dementia care

Team seeks to improve the projections of the future burden of the disease.

PORPP Dir & Prof Anirban Basu — CHOICE Institute at UWSOP Director & Professor Anirban Basu

Anirban Basu, director of the CHOICE Institute at UWSOP, and professor in the schools of Pharmacy and Public Health at the University of Washington, received more than $230,000 from the National Institutes of Health to measure the current and future costs of care for people with dementia. The research is part of a sub-grant from the University of Pennsylvania.

Dementia care has substantial economic costs, with consequences for health care systems as well as for the health and well-being of families who provide care for loved ones with dementia.

Anirban, also an adjunct professor of economics, will work with Paul Fishman and Lindsay White, a professor and postdoctoral fellow, respectively, in the Department of Health Services at the UW School of Public Health. In this study, the research team will take steps to improve the measurement of current dementia care and improve the projections of the future burden of the disease.

Researchers aim to estimate the direct and indirect costs of dementia care, including costs to caregivers, and to assess how costs vary with insurance and care providers. They also plan to develop a forecasting model to estimate the future costs of dementia care in order to inform resource allocation decisions.

The study will be conducted in collaboration with Norma Coe, associate professor of medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania, who leads the parent grant.

This research was supported by the National Institute on Aging under award number R01AG049815.

This story was written by Ashlie Chandler and shared with the permission of the UW School of Public Health.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

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CHOICE PhD student Landaas studies PupilScreen app in Thailand

Erik Landaas, current CHOICE PhD student pictured with CHOICE alumnus, Nathorn Chaiyakunapruk, PhD, in Thailand

CHOICE PhD student Erik Landaas received funding to conduct a mobile health validation study in Thailand. The study is funded by Washington Research Foundation (WRF) and his primary co-investigators include two UW School of Nursing PhD candidates.

PupilScreen a newly developed smartphone app that screens for traumatic brain injuries (TBI) and concussions was developed in collaboration with graduate students from UW Computer Sciences, and UW Neurosurgery.

Erik and his co-investigators will be in Thailand in December 2018 to train nurse research assistants, and co-develop the clinical protocol with the two hospitals in Phitsanulok; and is partnering with Naresuan University.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

Link to CHOICE Institute archived news

Kai Yeung receives grant for project looking at value in prescription drug benefit design

Kai Young, PhD, '15 — Kai Young, PhD, ’15

Congratulations to CHOICE Institute alumnus and Affiliate Assistant Professor, Kai Yeung, PharmD PhD, `15, who received a research grant from the Patrick and Catherine Weldon Donaghue Medical Research Foundation’s Greater Value Portfolio program.

Kai’s project is entitled, “Value-based Formulary-Essentials: Testing and Expanding on Value in Prescription Drug Benefit Design.”

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

Link to CHOICE Institute archived news

Anirban Basu awarded Mid-Career Excellence Award by HPSS

At the 2018 International Conference on Health Policy Statistics (ICHPS) held in Charleston, South Carolina, Anirban Basu was awarded the Mid-Career Excellence Award from the American Statistical Association Section on Health Policy Statistics (HPSS). Anirban was exceptionally and uniquely qualified for this award. Highlights include his providing outstanding service to the HPSS, advancing statistical methodology, advancing methodology in other domains of health policy, and performing extensive and highly impactful applied work in medicine and health care. In this interview, we trace Anirban’s upbringing, schooling, early career, and mid-career phases to gain insights into his success. We also sought his opinions on salient topics or issues.

The Mid-Career Excellence Award is eligible to persons who are within 15 years of their most significant degree. Having obtained his Ph.D. in 2004, Anirban met the eligibility criteria for the 2018 award. Anirban transitioned from Ph.D. student in 2004 to full professor in 2014, subsequently receiving a named and endowed full professorship in 2015. His is currently the Professor and Stergachis Family Endowed Director of The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute at UWSOP.

Read more about his nomination and his career development in “A conversation including 39 questions with Anirban Basu” published by Health Services and Outcomes Research Methodology.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

Link to CHOICE Institute archived news

Barthold uses economics methods to improve dementia diagnosis and treatment plans across race, ethnicity, and sex

“Economists have a knack for identification strategies—using data in innovative ways to isolate the role of one specific drug and separate it from other confounders that may affect the outcome of interest,” said Doug (pictured right, with CHOICE PhD graduate student Erik Landaas).

The newest researcher in The CHOICE Institute at UWSOP, Doug Barthold is taking a couple of approaches that use data and economic modeling to find potential treatments and trends in care of people with Alzheimer’s disease and related dementias (ADRD).

At press time, there are no known drugs that can prevent or delay the onset or progression of Alzheimer’s, so some researchers, including several at UWSOP, are examining the repurposing of existing drugs to help mitigate or delay the onset of Alzheimer’s.

Doug is looking at data on patient prescription drug use to find patterns that may suggest which drugs are protective and which may lead to dementia. “It’s important to know how drugs affect ADRD risk, both positively and negatively. Sometimes, we find protective drugs,” said Doug.

“Overall, it’s vital to understand long term effects of different drug molecules for people of different race, ethnicity, and sex. Using econometric tools and methods in large and diverse samples of data can offer clinical implications for care that can improve patient outcomes.” —Doug Barthold, Research Assistant Professor of Pharmacy and Plein Center Researcher

Similar to Zach Marcum, Doug has been researching anti-hypertensives, using Medicare claims and the Adult Changes in Thought study (ACT), which is currently administered in the Kaiser Permanente Washington health care system. The ACT data goes back to the 1970s and is useful for identifying mid-life risk factors for late life dementia.

In using the Medicare claims data, Doug partnered with a neuroscientist to examine AD risk for users of the four most popular statin molecules, by sex, race, and ethnicity. For example, he found decreased AD risk in African-American women who used simvastatin.

In addition to studying drug repurposing options, Doug’s research looks at patterns of care after dementia diagnoses, and what might affect the disease’s progression, including the management of comorbidities. By looking at diagnoses and treatment practices, he examines if there are racial disparities in the types of care that affect long term patient health. For example, patients that see a specialist for their Alzheimer’s care generally receive treatments that lead to better outcomes.

Using Medicare data, Doug is assessing various health system characteristics that might contribute to these disparities. Understanding those trends can raise awareness of the steps that health care providers, patients, and their families can take to manage the disease optimally.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Collaboration with UWSOP results in health benefits against flu for Era Living residents

UWSOP PharmD student presents to Era Living residents

Last year’s flu season was one of the worst in nearly a decade. The people most susceptible to the flu are our most vulnerable people: infants and children, older adults, and people who are chronically ill or have suppressed immune systems.

As alarming reports about how virulent last year’s virus was, Era Living, a top-rated group of local senior living communities, turned to their trusted partners at UWSOP for solutions. Through a program of training and education, UWSOP’s initiatives meant that Era Living avoided an outbreak and stayed open for most of the flu crisis.

Era Living communities are active and have many life-long learners as residents, including retired UW faculty. UWSOP and Era Living have a partnership designed to support residents’ health and create learning opportunities for our student pharmacists, under the mentorship of our faculty. Students and faculty regularly give well-attended talks on different subjects to empower the staff and residents in their own care. Topics include what to do to prevent contagious illnesses like pneumonia, whooping cough, and more.

The team pivoted and focused in on giving talks about the important adult vaccinations including for the flu: covering the importance of the vaccination, the difference it makes when more people who can get the flu shot get it, and, that even if you get the flu, it’s milder if you’ve had the flu shot.

The talks improved the vaccination rates as the SOP team reminded staff that flu shots and other vaccinations are a covered benefit, helped them understand the health benefits not just to themselves, but to their communities, and engaged the community in a little peer pressure (for the sake of good health) by reminding other residents and their families to get their shots and how it benefits everyone, particularly those who are sick, very young or old, or immune-compromised.

Taking care of older adults calls for some cautious steps to be taken from time to time. For example, it’s not unusual in the height of flu season for independent and assisted living communities to close to outside visitors, to protect the health of residents who may be vulnerable to these illnesses.

During last year’s flu season, which was one of the worst in a long time, Era Living facilities had to close very rarely to visitors—which surprised our faculty and students. When they did some research into why the communities were healthier, they found it went back to a series of talks given by the faculty and students on the importance of vaccinations. Era Living staff are invited to the talks as well, which led to a significant improvement during the last flu season. It turned out staff were in those presentations and it led to an increase in all staff getting flu shots, who regularly come in close contact with residents. Other protocols that were taught also helped the community stay strong, such as having residents stay in their apartment if they are sick.

The audience is wider than just the people in the room—it extends to their families, too. By staying up to date on their flu shots and other vaccinations residents protect their children, grandchildren, and great grandchildren when they visit.

The work of UW health providers and Era Living residents and staff shows that when people collaborate and actively learn how to improve their health, great results emerge.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Meet our Plein Center for Geriatric Pharmacy Preceptors: Neris Palunas

Neris Palunas, PharmD, BCPG — Neris Palunas, PharmD, BCGP

Neris M. Palunas, PharmD, BCGP, is a Consultant Pharmacist with Consonus Pharmacy, serving people in the Seattle area. Neris consults as a clinical pharmacist to senior living communities at all levels of care. “I love teaching and have been a preceptor in all my roles as a pharmacist, specifically as a Geriatric Pharmacy Preceptor for 4 years,” she told us.

She chose to specialize in geriatric pharmacy to, “honor the wisdom of our elders, advocate and bring comfort to the lives of older adults, optimize the use of medications in geriatric practice, and collaborate with the interdisciplinary health care team at transitions of care, pain management, rehabilitation and end of life.”Her research interests are in transitions of care and palliative care.

Previously, Neris worked in Global Health/Pharmacy Service in Central America, as Director of Professional Affairs for the WSPA, and in Professional Services and Drug Information for biotech giant Immunex Corporation.

Neris is a proud Husky alumna having earned her PharmD at UWSOP. For her undergrad degree, a BS in Pharmacy from the University of Illinois at Chicago, she focused on Pharmacy Administration. Additionally, Neris has piloted an airplane, is an outstanding cook and Lithuanian dancer. She enjoys annual backpacking trips with her son Kovas and daughter Vaiva. As for her coffee, she likes extra hot, triple shot venti lattes.

Are you interested in working with the top-rated faculty and preceptors while studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Meet our Plein Center for Geriatric Pharmacy Alumni: Cara McDermott

Alumna Cara McDermott, '11, '12, '16 — Alumna Cara McDermott, ’11, ’12, ’16

Alumna Cara McDermott, PharmD, PhD, MSc, ’11, ’12, 16, is a K12 Scholar in the UW Implementation Sciences Training Program and Acting Instructor, Cambia Palliative Care Center of Excellence, UW School of Medicine.

A three-time alumna of the UW School of Pharmacy, Cara said she chose to pursue the Plein Certificate in Geriatric Pharmacy in 2011 because she liked working with older adults and geriatric pharmacy combined her primary research interests in oncology and palliative care.

During the certificate program, “I learned a great deal about providing high-quality care as the result of working in various healthcare settings and completing research during the certificate,” she said. “My rotations in critical care, oncology and palliative care led me to my research today.”(Read more about her research project, “Care Coordination and Low-Value Care at End-of-Life Among Patients with Advanced Cancer,” here.)

The holistic approach to training Cara received during the certificate helped her think beyond the physical aspects of illness to consider social and environmental factors that may impact the health of older adults, such as insufficient caregiver support or needing access to supplemental insurance.

A little fun fact about Cara–she is originally from New Jersey and has hugged Bruce Springsteen! As for her coffee, she likes a tall triple shot skim latte.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Meet our Plein Center for Geriatric Pharmacy Faculty: Leigh Ann Mike

Leigh Ann Mike, Plein Center Assistant Director for Outreach and Clinical Associate Professor

Learn the latest about the deprescribing education and outreach UWSOP faculty member Leigh Ann Mike provides to older adults and providers.

Leigh Ann Mike, PharmD, is Clinical Associate Professor, Department of Pharmacy and Assistant Director for Education, Plein Center for Geriatric Pharmacy Research, Education and Outreach at the UW School of Pharmacy.

“I did not follow a traditional pathway to geriatrics. For many years I worked in a critical care unit in a hospital, but did not at that time consider myself a geriatrics pharmacist. One day, when I was completing a continuing education course with a focus on geriatrics, I realized that I was already incorporating the knowledge, skills, and principles of geriatric pharmacy in my everyday work. That really changed my perspective. It really brings home the fact that no matter what setting you work (with the exception of pediatrics), you are, and should think of yourself, as a geriatrics pharmacist.”–Leigh Ann Mike, Plein Center Assistant Director for Outreach and Clinical Associate Professor at UW School of Pharmacy

We asked her about her work with deprescribing and its impact on patient care. While the term deprescribing is relatively new, pharmacists, particularly those who work in geriatric pharmacy, have had this approach as part of their practice for many years. And word of the benefits of this form of patient care is starting to spread. This past summer, for example, Leigh Ann delivered a presentation at the American Diabetes Association on deprescribing for older adults with diabetes.

Additionally, Leigh Ann conducts educational sessions for audiences of older adults about deprescribing to give them some tools to advocate for themselves and encourage them to ask their prescribers about simplifying their medication regimens. “In my daily practice as a consultant pharmacist working with individual patients, I routinely and intentionally think about how to simplify each person’s medication regimen, sometimes referred to as decreasing medication burden,” Leigh Ann. Through these educational efforts, she works with nurses and older adults who regularly seek out her professional opinion and advice on how to talk to prescribers about simplifying medication regimens. As she works with more providers and older adults, she hopes these grass roots efforts will spread so more people will enjoy the beneficial impact of deprescribing on their overall health.

A fun fact about Leigh Ann is that she lived in Europe twice during her elementary school years and still retains a little bit of her German language skills. Her coffee preference to jump-start the day: dark roast, very strong, with just a touch of sugar.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Marcum takes a multi-prong approach toward developing a dementia prevention strategy

Zach Marcum, Plein Center Assistant Director of Research and Bailey Faculty Fellow and Assistant Professor of Pharmacy Photo: Alex Levine

The prospect of developing dementia is terrifying for most people, particularly for those with family members who have had the disease. Many wonder what they can do to prevent the onset of dementia—which is where the research of the Plein Center for Geriatric Pharmacy has some answers.

Experts know there are healthy habits that will make a difference—exercising regularly, managing heart health, staying intellectually challenged and being connected socially, are among those habits.

Zach Marcum surveyed Kaiser Permanente Washington (KPW) members (1661 total) to learn more about their attitudes and beliefs toward health habits and what they could do to ward off the onset of dementia. Of the survey respondents, most believed that it is possible to improve brain health and reduce their risk of dementia, but one-third lacked confidence that they could take action to reduce their risk. Health habits like managing mid-life hypertension, socializing, and keeping the mind sharp with learning, new activities, and exercise make a difference.

“Dementia is not an inevitable part of the aging process. There are steps people can take right now to reduce the risk of the disease—and it’s never too late to start. We are investigating repurposing medications as a dementia prevention strategy.” —Zach Marcum, Plein Center Assistant Director of Research and Bailey Faculty Fellow and Assistant Professor of Pharmacy

Zach’s study is looking at what the experts say and what the public knows to understand what the gaps are between public and expert knowledge. By understanding the gaps, he anticipates being able to improve public health communications and care recommendations. Additionally, it’s been shown that the earlier Alzheimer’s Disease and related dementias (ADRD) are diagnosed, the better the outcomes are for the patient, making it important to find new ways to detect undiagnosed dementia.

Using the KPWHRI data, he looked at the historic patterns of chronic medication use in patients who are later diagnosed with dementia, prior to that diagnosis. He found that patients with sub-optimal adherence to taking anti-hypertensives were more likely to develop dementia.

Moreover, one of the most promising areas for dementia prevention is managing mid-life cardiovascular risk. One such risk factor is cholesterol. Zach is using the KPW data to examine how cholesterol levels from mid-life onward are associated with late-life dementia. He found both low and high levels of non-HDL (“bad cholesterol”) were associated with an increased risk of future dementia. “It makes sense that high levels of bad cholesterol would increase the risk of dementia,” notes Zach, “but it’s not as clear why the low levels of bad cholesterol do.”

In addition, Zach is looking at medications that might be repurposed to ward off or delay the onset of dementia. This approach aims to investigate the repurposing of blood pressure medications as a dementia prevention strategy.

“Like so many people, I’ve seen first-hand the effect Alzheimer’s disease has on patients and their family members—and that motivates me to find solutions,” said Zach.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Plein Center students and faculty research highlighted at ASCP’s annual meeting

Plein Certificate students Julia Yunkyung and Jina Yun, pictured with Julia's ASCP poster — Plein Certificate students Julia Yunkyung and Jina Yun, pictured with Julia’s ASCP poster

Our School’s faculty and students presented two posters at the ASCP Annual Meeting, and the abstracts are in the October issue of The Consultant Pharmacist.

Julia Yunkyung, Laura Hart, and Shelly Gray presented a poster titled, “Definition of fall risk-increasing drugs in the literature: Challenges and implications.” We know falls in older adults can be extremely dangerous, resulting in serious injuries, even death. The team looked at nine studies that evaluated fall risk-increasing drugs (FRID) use in older adults with a recent fall and categorized them by subcategories, such as central nervous system (CNS)-active, cardiovascular, and other. The number of subclasses included in FRID definitions ranged considerably from 6 to 15. The authors found, “inconsistent definitions of FRIDs have implications for evaluating prevalence of FRID use and identifying or prioritizing medications to target for interventions.”

Jina Yun and Leigh Ann Mike presented a poster titled, “Student-pharmacist-led fall risk outreach event in older Korean adults: Summary of participants’ experience and satisfaction,” at the conference. Working with a community of older Korean adults, student pharmacists planned an event to screen and educate attendees on fall risks and osteoporosis. They developed a questionnaire and performed osteoporosis screening by measuring bone density at the ankle. Of those who participated, about a quarter had a fall and half had discussed fall risk with their physician prior to the event. Many of the participants were illiterate in English, Korean, or both languages. The team found that, overall attendees “had a positive experience at the student-pharmacist led event and would benefit from ongoing outreach events that identify and meet their health needs.”

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Barker-Haliski’s novel research looks at the under-studied problem of epilepsy in patients with Alzheimer’s

Melissa is a neuropharmacologist with a passion for understanding how drugs work in the body. Her research is supported by the UW Royalty Research Fund and the UWSOP Plein Fund Endowment. She and her team will present findings in December 2018 at the American Epilepsy Society meeting. Melissa works in collaboration with Suman Jayadev, associate professor of neurology at UW Medicine and the clinical core director of UW’s Alzheimer’s Disease Research Center. — Melissa is a neuropharmacologist with a passion for understanding how drugs work in the body. Her research is supported by the UW Royalty Research Fund and the UWSOP Plein Fund Endowment. She works in collaboration with Suman Jayadev, associate professor of neurology at UW Medicine and the clinical core director of UW’s Alzheimer’s Disease Research Center.

People with Alzheimer’s disease can have up to an 87-fold increased risk of seizures. Patients with early-onset Alzheimer’s have the highest risk for seizures, but even patients with late onset Alzheimer’s disease are at high risk.

Despite the risks, little is known about how genes associated with Alzheimer’s disease may affect a person’s susceptibility to seizure across their lifespan. Even less is known about whether anticonvulsant drugs, which, historically, have been tested in young-adult animal models, are effective and well-tolerated in older populations, including those with Alzheimer’s.

Plein Center researcher Melissa Barker-Haliskihopes to answer this question using preclinical mouse models with Alzheimer’s disease-associated genetic risk factors. Melissa is a neuropharmacologist with expertise in preclinical epilepsy models for anticonvulsant drug discovery. In collaboration with neurogeneticist and UW School of Medicine’s Suman Jayadev, MD, Melissa and her team are investigating how seizures in these preclinical Alzheimer’s disease models age-dependently affect disease trajectory and cognitive outcomes, as well as how anticonvulsant drugs affect seizure control in mice with these Alzheimer’s disease-associated risk genes. Using a mouse model with a mutation in one of the most common early-onset Alzheimer’s disease-associated risk genes (presenilin 2 [PSEN2]), they see how age affects the mice’s susceptibility to seizures and whether those seizures age-dependently respond to available anticonvulsant medications.

Melissa Barker-Haliski's findings suggest that if a patient is having seizures and has an Alzheimer’s diagnosis, anticonvulsant therapies may effectively stop their seizures. — Melissa Barker-Haliski’s findings suggest that if a patient is having seizures and has an Alzheimer’s diagnosis, anticonvulsant therapies may effectively stop their seizures.

Melissa and her former undergraduate student, Megan Beckman (BS ’18), will present this research at the Investigator’s Workshop of the 2018 American Epilepsy Society Annual Meeting. Megan received one of 20 highly competitive Young Investigator’s Award from the American Epilepsy Society to offset the costs to present this research work in December in New Orleans, LA. Melissa and Megan’s research shows that many of the approved anticonvulsant medications reduce seizures in aged mice that carry the PSEN2 mutation.

However, clinical studies in Alzheimer’s disease patients are still needed. This work points to the potential positive impact anticonvulsants have on seizures in adults with Alzheimer’s disease, and also may inform anticonvulsant medication usage in the general population of older adults. As older adults represent the fastest growing patient demographic with epilepsy diagnosis, preclinical and clinical studies of anticonvulsant drugs in these individuals is clearly warranted.

“An implication of our findings is that patients with Alzheimer’s disease could benefit if clinicians and neurologists examined their patients early in the disease course to determine if they are experiencing seizures.” —Melissa Barker-Haliski, Research Assistant Professor, Pharmacy

From a clinical perspective, the good news is Melissa’s preclinical research aligns with the few clinical studies demonstrating that anticonvulsant drugs often work well in older adults, which may indicate their seizures can be controlled. People with Alzheimer’s disease commonly present with seizures that are not the “grand mal” type with generalized tonic-clonic convulsions. Seizures in older adults are often focal or what’s historically called complex partial seizures—which can seem like a mild stroke or may be called a “spell”—and patients may be disoriented afterward. These seizures can be difficult to distinguish from common symptoms of Alzheimer’s disease, making it challenging for clinicians, patients, and their families to recognize when and if seizures occur, further delaying anticonvulsant use.

Some anticonvulsant drugs can even impair cognitive function in patients with epilepsy, so their use in people with Alzheimer’s disease is a decision clinicians, patients, and their families should weigh carefully, given their promise to help. Melissa’s work provides preclinical evidence that will inform the clinical studies of seizure control in patients with Alzheimer’s disease. Her ongoing studies within the Plein center support growing recognition in the neurology community that seizures in patients with AD are a common, potentially detrimental, and often under-diagnosed component of the disease.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

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Werth receives prestigious Young Investigator Award from SIDP

Brian Werth, assistant professor of pharmacy, in his lab Photo: Alex Levine

Congratulations to Assistant Professor Brian Werth who received this year’s Young Investigator Award from the Society of Infectious Diseases Pharmacist (SIDP). The prestigious award is given to a young investigator who shows research promise in the broad area of infectious diseases.

Brian has demonstrated tremendous research productivity over the past 5 years at the University of Washington School of Pharmacy. His multidisciplinary, translational research program has focused on antimicrobial dosing strategies that optimize efficacy and prevent or overcome resistance in multidrug resistant pathogens. He has made significant contributions to infectious diseases research through education, mentorship, and service.

Since beginning his academic appointment, he has published 22 peer-reviewed papers and received research support from SIDP, pharmaceutical industry, and the National Institutes of Health. He was recently awarded a 4-year, $1.86 million NIH R01 grant as principal investigator, which is an exceptional accomplishment for a young investigator.

Brian and grant coinvestigator UWSOP Medicinal Chemistry’s Libin Xu will continue their novel research into antibiotic resistance mechanisms in the superbug, methicillin-resistant Staphylococcus aureus(MRSA). With Libin’s expertise in ion mobility-mass spectrometry (IM-MS) analysis of lipids and Brian’s expertise in antibiotic resistance, they are working to understand the mechanisms of cross-resistance among antibiotics that target the bacterial cell membrane and cell wall. This work could lead to the identification of novel targets for resistance-modifying therapeutics or more sensitive diagnostics to detect resistance. In addition, the team received a UW Royalty Research Fund award of $38,175 for their project, “Targeting Altered Lipid Metabolism in Antiobiotic-Resistant Staphylococcus Aureus.” The RRF is funded from royalty and licensing fee income generated by the UW technology transfer program. The fund supports UW faculty seeking to advance new directions in research in disciplines for which external funding opportunities are minimal; for faculty who are junior in rank; and if the award might provide opportunities to increase applicants’ competitiveness for subsequent funding.

To read more about Brian’s collaboration with Libin Xu began with an outing to the College Inn Pub and a new UWSOP Faculty Innovation Grant, click here.

UW Researchers Gray and Phelan to study the impact of deprescribing to reduce falls in older adults

UW Pharmacy’s Shelly Gray and UW Medicine’s Elizabeth Phelan are teaming up to identify ways to prevent falls in older adults. Their study, “Reducing Central Nervous System (CNS)-active Medications to Prevent Falls and Injuries in Older Adults (STOP-FALLS),” will identify medication safety improvements to reduce fall-related injuries and other adverse health outcomes.

“Falls in older adults are a significant public health issue, and many older adults are on risky medications that may cause falling because they cause side effects such as dizziness, drowsiness and impaired cognitive abilities. This study will help health care providers and patients reduce use of these risky medications, including opioids and benzodiazepines, to prevent falls. Finding ways to optimize medication use and safety in older adults is the major mission of the Plein Center.”—Shelly Gray, Director, Plein Center for Geriatric Pharmacy and Shirley & Herb Bridge Endowed Professor at UWSOP

Shelly Gray, Director, Plein Center for Geriatric Pharmacy and Shirley & Herb Bridge Endowed Professor at UWSOP

Gray and Phelan received a $3M grant from the Centers for Disease Control and Prevention (CDC) to study the effect of reducing the use of medications, such as benzodiazepines and opioids, on preventing falls and other unintentional injuries in older adults. These medications are prescribed for conditions such as pain, anxiety and sleep disorders. The team will study the impact that deprescribing can have on people’s safety and reducing the risk of falling, particularly given the impact multiple medications can have on a person’s physical and cognitive functioning.

Deprescribing is a process whereby the pharmacist and physician review a person’s medications to see if any medications may be causing harm or may no longer be helping the patient. Sometimes a medication that was safe when the person was younger now may pose a risk as they age because the body changes. By going through this review and making adjustments, some patients experience reduced side effects.

“There has been surprisingly little attention as yet to addressing the role of medications in falls and injuries by the practice community. We need practical, patient-centered, and health-system-relevant approaches to curtail unnecessary use of CNS-active medications, and prevent their future use, if we are to ever see sustained reductions in fall-related injury rates and avert the adverse, life-changing consequences that result when an older person is seriously injured from a fall,” —Dr. Elizabeth Phelan, geriatrician and medical director, Fall Prevention Clinic, Harborview Medical Center, and an Associate Professor of Medicine, University of Washington School of Medicine.

Dr. Elizabeth Phelan, geriatrician and medical director, Fall Prevention Clinic, Harborview Medical Center, and an Associate Professor of Medicine, University of Washington School of Medicine

Reducing fall rates is important. In just ten years, from 2007 to 2016, the death rate caused by falls for older adults has increased 30% in the U.S. If rates continue to rise, the Centers for Disease Control and Prevention (CDC) says we can expect seven fall deaths every hour by 2030. One in five falls causes a serious injury such as broken bones or head injury and sends about three million older adults to the emergency room every year at a cost of about $50 billion dollars, most of which is shouldered by Medicare and Medicaid.

The grant is one of three funded by the CDC’s National Center for Injury Prevention and Control (Injury Center) that will focus on medication management of opioids and benzodiazepines to reduce falls among adults aged 65 years and older. The research will be conducted at Kaiser Permanente Washington with Dr. Karen Sherman serving as the site lead.

This award is one of three extramural research cooperative agreements funded (RFA-CE18-004) to focus on medication management of opioids and benzodiazepines to reduce falls among adults 65 and older.

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Researchers at UW and USC find a type of medication used to treat high blood pressure may reduce the risk of Alzheimer’s disease

Doug Barthold, Research Assistant Professor, The CHOICE Institute at the UW School of Pharmacy

Researchers Doug Barthold of the University of Washington and Julie Zissimopoulos of the University of Southern California published the first study to compare multiple types of blood pressure medications and the beneficial effect they may have on different populations. Unlike other studies, they looked at how Alzheimer’s disease risk was reduced across race, ethnicity, and sex.

Their study findings suggest that hypertension management in older adults with a type of anti-hypertensive called ARBs (angiotensin-II receptor blockers) could reduce the risk of Alzheimer’s disease for black women, and white women and men. (The study was inconclusive for black men, and Hispanic men and women).

As of press time there are no medications known to prevent or delay the onset or progression of Alzheimer’s disease. Increasingly, researchers are looking to existing medications, used for treatment of other chronic conditions, to see if they could be repurposed to fight against cognitive decline and lower the risk of Alzheimer’s disease.

Repurposing existing drugs could be an inexpensive means to reduce the large and disparate burden of Alzheimer’s disease. By analyzing commonly used prescription drugs in Medicare claims data, we can identify relationships with Alzheimer’s disease onset across diverse populations.

There is strong evidence that managing high blood pressure is an important step to lowering the risk of Alzheimer’s disease and that some antihypertensive drugs may be more protective than others.

The research team’s retrospective cohort analysis looked at how different classes of anti-hypertensives are protective against Alzheimer’s disease. They looked at over 1 million Medicare enrollees and found antihypertensive drug types called ARBs, angiotensin-II receptor blockers, such as Valsartan (Diovan), Candesartan (Atisan), and Losartan (Cozar), are more protective than other anti-hypertensives, such as ACE inhibitors and four other classes of drugs.

The team concluded that the results were significant enough to warrant additional observational studies and randomized control trials that include men and women from diverse racial and ethnic groups, to investigate if there is a causal effect.

Alzheimer’s disease is a growing public health problem. Right now over 5 million Americans aged 65 and older are living with Alzheimer’s disease and that number is expected to grow to 7.1 million in 2025, and 13.8 million in 2050. At those levels, even small delays in the onset of Alzheimer’s disease could substantially reduce the financial ($300+ billion in 2010) and caregiving burden (18+ billion hours of care in 2016—over forty percent of which is provided by informal caregivers, often family and friends).

Add to those statistics the fact that there is a higher incidence of Alzheimer’s disease for women and racial and ethnic minorities, who are also more likely to require high intensity care and have unmet care needs, and you have an emerging public health crisis ahead.

Researchers worldwide are looking for solutions to stop or mitigate the impact the disease has on population health. Targeted hypertension treatment could reduce the large, growing, and disparate burden of Alzheimer’s disease on the afflicted individuals, their caregivers, and the health system as a whole.

This study indicates that if there is a choice in anti-hypertensive medications, there is a potential additional benefit for using targeted treatments against Alzheimer’s disease, but that it needs to be confirmed by additional research.

“Alzheimer’s disease is an enormous public health concern and while more than a hundred potential drug treatments are in clinical trials, there are still no treatments available to prevent or slow the progression of the disease. Research is building that AHTs reduce risk of dementia and this study suggests a potential pathway independent of blood pressure effects. All else being equal, for patients who are already being prescribed antihypertensives these findings highlight a potential differential effect on their risk of acquiring Alzheimer’s which a clinician may want to take into account,” said Zissimopoulos who is the director of the aging research program at the USC Schaeffer Center and Vice Dean of Academic Affairs at the USC Price School of Public Policy.

The paper, titled “The association of multiple anti-hypertensive medication classes with Alzheimer’s disease incidence across sex, race, and ethnicity,” was published in the journal PLOS ONE on November 1, 2018 with co-authors Geoffrey Joyce of USC, Whitney Wharton of Emory University, and Patrick Kehoe, University Bristol, UK. This research was supported by the National Institutes of Health (NIH), awards R01AG055401, RC4AG039036-01, P30AG043073-01, K01AG042498, R01HL126804, and R01HL130462

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Lou Garrison named 2018 Value Assessment Challenge Award recipient

The PhRMA Foundation and the Personalized Medicine Coalition (PMC) announced that Lou Garrison is one of the first place recipients of the 2018 Value Assessment Challenge Awards. These awards are designed to encourage innovative approaches in defining and measuring value in health care. Lou and the other award recipients were recognized for submitting research proposals that focus specifically on novel methods for assessing the value of personalized medicine.

A total of $85,000 in funding was provided for the researchers, who answered the question: What are potentially transformative strategies and methods to define and measure value at all levels of decision making that are aligned with personalized/precision medicine?

Louis serves as faculty emeritus at University of Washington School of Pharmacy and Visiting Senior Fellow at the Office of Health Economics and collaborated with Adrian Towse, MPhil, MA, Office of Health Economics, London, England on the Research Proposal that garnered the $50,000 first place award.

“Adrian and I are really pleased and honored to receive this award. Our proposed strategy weaves together various threads of our joint research over the past ten years—much of it in collaboration with others in our field. We recognize the new challenges for health technology assessment and financing stemming from the exciting recent developments in precision medicine, and we call for greater focus on rewarding value creation to support optimal long-term innovation.”

—Lou Garrison, Faculty Emeritus, UWSOP

In their research proposal, “A Strategy to Support the Efficient Development and Use of innovations in Personalized and Precision Medicine,” Garrison and Towse call for a broadening of the concepts of value in personalized/precision medicine, laying out six basic policy principles as pathways to help determine value. These range from the need for flexible, value-based pricing to real-world evidence generation in personalized/precision medicine and the challenging implications for assessing and rewarding value.

The Challenge Awards, first offered in 2017, are one component of the PhRMA Foundation’s multi-faceted Value Assessment Initiative, which supports a variety of research and innovation projects to help the United States make a successful transition to a value-based health care system.

Concern over rising U.S. health care costs in recent years has increased interest in promoting high-quality care while avoiding low-value or inefficient care. In response, various efforts aimed at driving value in health care have emerged, but few have offered transformative solutions that reflect patient preferences and real-world clinical practice.

Recipients of Challenge Awards will be acknowledged during PMC’s 14th Annual Personalized Medicine Conference at Harvard Medical School on Thursday, November 15th. They will be asked to present their winning papers at a public forum, to be announced later, where they will be honored for their work.

Award recipients will also become part of the Value Assessment Research Network, which has been established to encourage collaboration and dissemination of findings that emerge from various projects the Foundation is supporting through its Value Assessment Initiative.

“Working with PMC, the PhRMA Foundation is delighted to recognize and reward the innovative approaches to value assessment demonstrated in these outstanding research proposals,” said PhRMA Foundation President Eileen Cannon. “The work of these outstanding researchers will make a significant contribution to the effort to create truly value-based health care in the United States.”

To learn more about these awards, go to the PhRMA Foundation site.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about studying Pharmaceutical Outcomes Research and Policy at The CHOICE Institute at UWSOP.

Link to CHOICE Institute archived news

Organs-on-chips: Tiny technology helping bring safe new drugs to patients faster

File 20180525 90281 17z2fmg.jpg?ixlib=rb 1.1 — It doesn’t look like a kidney, but this ‘kidney-on-a-chip’ is a breakthrough for new drug testing.
Alex Levine, CC BY-ND

Catherine Yeung, University of Washington; Edward Kelly, University of Washington, and Jonathan Himmelfarb, University of Washington

Getting a new pharmaceutical from an idea in the chemistry lab to market takes many years and billions of dollars. Each year just several dozen new drugs are approved for use in the United States.

Human “organs-on-chips” are leading a revolution in drug safety testing. These devices use human cells to model the structure and function of human organs and tissues. By testing the potential effects of drugs on different organs faster than traditional methods, organs-on-chips can reduce the need for animal studies and better predict which new drugs will effectively treat human disease.

As part of an interdisciplinary research team, with funding support from the National Center for Advancing Translational Sciences, we’re working on a kidney-on-a-chip to improve our understanding of how kidney diseases begin and which drugs can safely treat them.

Quicker and better testing

Historically, laboratory testing for new drugs is performed in cells grown in dishes or flasks. If a drug passes initial screening tests in vitro, researchers next test it in vivo in live animals to determine the effects of a new drug on a whole system instead of just one cell type at a time. Finally, after many years of laboratory investigation, researchers will test a promising new drug in people to see if it is safe and effective.

The problem is 9 out of 10 of these drugs never make it from small-scale human tests to the patient because they turn out to be ineffective or toxic, even if they showed promising results in early testing.

Organs-on-chips have the potential to completely transform that system. Ranging from the size of a fingernail to that of a credit card, they’re composed of fluid channels and tiny chambers that contain human cell samples. Organs-on-chips in development in labs around the country include kidney, lung, liver, intestine, skin, brain, heart, bone and reproductive systems.

In an organ-on-a-chip, flowing liquid supplies the cells with oxygen and nutrients, similar to the way blood sustains cells in the human body. It’s this constant flow that makes these devices special. Cells grown in organs-on-chips devices act more like cells in a human organ than do cells grown in flat dishes without flow.

Fluid circulates through a kidney-on-a-chip.
Alex Levine, CC BY-ND

Case of the kidney-on-a-chip

Kidneys are incredibly important to overall human health. The two fist-sized kidneys remove drugs and unwanted compounds from the body and play a critical role in maintaining proper salt and water balance, blood pressure and vitamin D and bone health. Genetic conditions and even commonly administered medications can, in some circumstances, damage the kidneys.

In the U.S., 15 percent of adults have kidney diseases. But most don’t even know it, because kidney diseases often display no symptoms until the condition is very advanced. There’s a pressing need to understand how kidney disease begins, and to develop new safe and effective treatments.

Here at the University of Washington, our kidney-on-a-chip research team is composed of scientists from many different disciplines, including pharmacy, pharmaceutical sciences, nephrology (kidney medicine), toxicology, biochemistry and bioengineering.

In partnership with Nortis, Inc., a local biotechnology company, our team has created a small device — the size of a business card — with up to three tiny tubes, each one-thousandth the size of a drop of water, containing 5,000 human kidney cells. When tiny amounts of fluid are pumped through the tubes, the kidney cells are exposed to important signals that help the cells in the chip behave as if they were in a live kidney.

We’ve found that the kidney cells release signals – called biomarkers – of injury when exposed to known kidney toxins. Our research showed that cells on the chip released markers of injury commonly seen in the urine of people with kidney damage. Testing with the older method, using cells on plates, did not show any damage with the same treatment. This suggests that the kidney-on-a-chip may be better than existing methods at predicting if a new drug will cause kidney damage in humans.

These devices do a better job of testing how molecules affect living human cells.
Alex Levine, CC BY-ND

Connecting organs-on-chips to mimic systems

Now that we’ve had these promising results, scientific teams across the country are starting to connect different organs together to replicate a more complex, multi-organ system, to give greater insights into how drugs affect people. For example, we were able to connect a liver-on-a-chip to a kidney-on-a-chip to learn how a plant extract used in some herbal medicines, called aristolochic acid, damages kidney cells. This chip-to-chip investigation reinforces the need for interconnected organs-on-a-chip to replicate the complex mechanics in the human body.

In the coming year, our kidney-on-a-chip project will be one of several sent to the International Space Station where low gravity speeds up changes in cells, sometimes causing health problems for astronauts. The Space Station could be the perfect place to find out more about kidney diseases in weeks, rather than years or decades.

Organs-on-chips can also be used to discover new drug targets. Our team is evaluating the kidney-on-a-chip as a tool to personalize drug selection and dosing in people with kidney cancer, polycystic kidney disease and chronic kidney disease. Other organs-on-chips labs around the country are studying diseases of the immune system, brain, lungs, heart and blood vessels. By working together, dozens of research teams are developing this new technology to revolutionize drug discovery, leading to the development of better and safer medications for all.

See how it all works in this video animation.

Catherine Yeung, Research Assistant Professor of Pharmacy, University of Washington; Edward Kelly, Associate Professor of Pharmaceutics, University of Washington, and Jonathan Himmelfarb, Director of the Kidney Research Institute and Professor of Medicine, University of Washington

This article was originally published on The Conversation. Read the original article.

Strand awarded 2018 Garrison Prize in Health Policy & Economics

CHOICE doctoral student and Garrison Prize recipient, Lauren Strand

Congratulations to 3rd year, PhD student Lauren Strand who received the Louis Garrison Sr. And Marilyn Garrison Endowed Prize in Health Policy and Economics prize! Lauren’s paper is titled “New Statin use and left ventricular structure: Estimating long-term associations in the Multi-Ethnic Study of Atherosclerosis (MESA).”

Laurent’s research looked at recent clinical guidelines that have increased the number of individuals eligible for treatment with statin drugs. Statin users are now younger and expected to use these drugs for extended periods. Statins are reported to have “pleiotropic effects” where some effects may be beneficial to cardiovascular health outside their capacity to lower cholesterol. However, statins are known to have negative effects on skeletal muscle.

Lauren’s paper entitled “New statin use and left ventricular structure: Estimating long-term associations in the Multi-Ethnic Study of Atherosclerosis (MESA)” focused on estimating the effect of statin use on the structure of the heart. To date, small and short‐term studies of this relationship have demonstrated very large effect sizes. This study in a large, diverse cohort demonstrated a modest association between statin use and reduced remodeling of the left ventricle (i.e. reduced change in mass) in a propensity score matched model. Overall findings suggest that any (small) statin effect on cardiac remodeling is likely not the main mechanism of statin benefit in the primary prevention of heart failure.

In future analyses, she plans on considering incorporating clinical outcomes and evaluating the relationship between other classes of medications (e.g. antihypertensive drugs) and heart structure.

The Garrison Prize is intended to recognize annually an outstanding research paper in the area of health policy and economics. CHOICE Professor Emeritus Louis Garrison, Jr and his wife, Fran, established this fund in 2008 in fond memory of his parents who were great believers in the value of higher education and science. We presented the award to Lauren at our annual retreat in May.

Congratulations to Lauren!

Advance your career in patient-centered outcomes research, geriatric pharmacy or pharmacy practice at the University of Washington. Learn more about our Pharmaceutical Outcomes Research and Policy Graduate Programs in The CHOICE Institute at UWSOP.

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Wienkers is keynote speaker at June 2018 AAPS-RMDG meeting at UW

Abstracts are due Friday, May 18, 2018

Keynote speaker Larry Wienkers is also a UWSOP Distinguished Alumni Award winner.

The American Association of Pharmaceutical Scientists – Rocky Mountain Discussion Group (AAPS-RMDG) Annual Meeting will be held at the University of Washington, Seattle, WA, on June 12-13, 2018. The deadline for abstract submission is May 18, 2018.

The RMDG provides a forum for interacting with scientists from industry and academia to promote basic and pharmaceutical sciences in the Rocky Mountain and Pacific Northwest regions. The highlights of this year’s annual meeting include:

Dr. Larry Wienkers, keynote speaker
Speakers from industry and academia, including students and postdoctoral fellows
Career panel
Poster reception

Tuesday, June 12 and Wednesday, June 13th at UW Seattle in the Alder Auditorium (1310 NE 40th Street, Seattle, Washington 98105).

For more information and to register or submit an abstract: http://bit.ly/aaps-rmdg-2018

Please note! Immediately following the RMDG conference, the 21st International Conference On Drug-Drug Interactions will be held at the University of Washington from June 14-16, 2018.

Certain drugs for muscle conditions may be linked to increased risk of dementia

Dr. Angela Hanson, geriatrics, reviewing medications with a patient at the Memory and Brain Wellness Center at Harborview Medical Center.

Shelly Gray editorial in The BMJ underscores importance of avoiding long-term use of anticholinergic drugs in older adults

UWSOP Plein Center for Geriatric Pharmacy Director Shelly Gray authored an editorial in support of new research about potential dangers of anticholinergic drugs for that help to control involuntary muscle movements for conditions such as epilepsy and Parkinson’s disease. The UK study, “Anticholinergic drugs and risk of dementia: case-control study,” published by The BMJ today, found these drugs are associated with an increased risk of dementia.

The study is the largest of its kind to date and the findings prompt the researchers to say that clinicians should avoid long term prescribing of some anticholinergics to patients aged 45 and over.

“This research “raises important issues about the best way to summarize anticholinergic burden for future research… Specifically, for most highly anticholinergic drugs, non-pharmacological and pharmacological alternatives are available and should be considered.” – UW Professor and Director Shelly Gray and Professor Joseph Hanlon at the University of Pittsburgh, in their editorial, “Anticholinergic drugs and dementia in older adults”

In the meantime, Gray and Hanlon agree that anticholinergics in general should be avoided in older adults.

Anticholinergic drugs block chemical signals to the brain that control muscle movements. They are often used for conditions linked to involuntary muscle movements, such as urinary incontinence, epilepsy and Parkinson’s disease, as well as for depression, chronic lung disease (COPD) and asthma.

Several studies have reported associations between use of anticholinergics and future cognitive decline and dementia, but it is not clear whether this is due to the drugs themselves or the underlying conditions for which they were prescribed.

So a research team led by Kathryn Richardson at the University of East Anglia, set out to estimate the association between duration and level of exposure to different classes of anticholinergic drugs and subsequent dementia.

They analyzed data from the UK’s Clinical Practice Research Database for 40,770 patients aged 65 to 99 years who were diagnosed with dementia between April 2006 and July 2015. Each case patient was matched to up to seven control patients of similar age and sex, but without dementia.

Drugs were scored according to their anticholinergic activity using the Anticholinergic Cognitive Burden (ACB) scale. An ACB score of 1 was classed as possibly anticholinergic, while a score of 2 or 3 was definitely anticholinergic.

Daily doses of each drug were then compared for both cases and controls over an exposure period of 4 to 20 years before a diagnosis of dementia.

A total of 14,453 (35%) cases and 86,403 (30%) controls were prescribed at least one anticholinergic drug with an ACB score of 3 during this period.

After taking account of potentially influential factors, the researchers found that definite anticholinergic antidepressants, anti-Parkinson drugs, and drugs to treat urinary incontinence (ABC score of 3) were linked to increased dementia risk up to 20 years after exposure.

However, no increased risk was found for drugs with possible anticholinergic activity (ACB score of 1) – and for anticholinergic gastrointestinal or respiratory drugs (ACB score of 3).

Other antidepressants (mainly selective serotonin reuptake inhibitors) with an ACB score of 1 were linked to dementia, but only close to the time of prescription, which the researchers say is unlikely to represent a direct (causal) link.

This is an observational study, so no firm conclusions can be drawn about cause and effect, and the authors outline some limitations, such as possible misclassification of dementia cases and a lack of information on depression severity. Nevertheless, the study was large and was able to account for several potentially influential factors.

Marcum study finds metformin has mortality benefits even with low kidney function

Collaborative research between UW School of Pharmacy and VA Puget Sound looked at 175,000 patients

Assistant Director of the Plein Center and Bailey Faculty Fellow Zach Marcum

In a recent study, researchers at the University of Washington and the VA Puget Sound Health Care System have found that an important diabetes drug can be used safely among a high-risk patient population – those with poor kidney function. They concluded metformin should be prescribed preferentially over sulfonylureas in this group of patients based on overall mortality benefits.

In 1995, the FDA approved metformin for patients with Type 2 diabetes; however, the label advised clinicians to avoid prescribing metformin to patients with impaired kidney function because of concerns about lactic acidosis. But in 2016, the FDA endorsed metformin’s safety in patients with mild-to-moderate kidney function impairment.

To determine whether risk for death differs following initiation of metformin monotherapy or sulfonylurea monotherapy among veterans with Type 2 diabetes and chronic kidney disease, Zach Marcum, Assistant Director of the Plein Center for Geriatric Pharmacy and Bailey Faculty Fellow, and colleagues conducted this cohort study of 175,000 older adult patients with diabetes and chronic kidney disease who initiated these drugs at Veterans Affairs medical centers between 2004 and 2009.

Their results showed that metformin had significant benefits over sulfonylureas across the stages of kidney function. Metformin use was associated with a 36% lower risk for death overall.

“This study should be reassuring to clinicians and to diabetic patients with impaired kidney function. Metformin should be prescribed preferentially over sulfonylureas in this group of patients.” – Paul Mueller, MD, MPH, FACP, reviewing the study for the New England Journal of Medicine Journal Watch

Metformin had been restricted as it was thought to have an unfavorable risk/benefit profile among people with low kidney function. However, in their research, Zach and the team found that metformin had mortality benefits.

Although residual confounding is possible, this study shows that initiation of metformin monotherapy versus sulfonylurea monotherapy among patients with Type 2 diabetes and mild-to-moderate kidney function impairment is associated with lower risk for death, which should be reassuring to clinicians and to diabetic patients with impaired kidney function.

The data reviewed were from 2003 to 2009, which is important because today people wouldn’t be prescribed a sulfonylurea as first-line treatment for type 2 diabetes, but during this timeframe there were substantial numbers of people being prescribed either metformin or a sulfonylurea as initial monotherapy.

The team grouped people into different levels of kidney function based on severity of impairment. They found benefits for people using metformin in both absolute and relative terms. Many studies stop at relative risk, but this one found a benefit to absolute risk as well. The largest absolute risk reduction was observed among individuals with the moderately-severely reduced kidney function. This is a group of patients for whom the FDA label currently advises to not start metformin. Future research is needed to confirm these findings.

Advance your career in patient-centered outcomes research, geriatric pharmacy or pharmacy practice at the University of Washington. Learn more about our Pharmaceutical Outcomes Research and Policy Graduate Programs in The CHOICE Institute at UWSOP.

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Link to Department of Pharmacy archived news

Basu trains Indian government and health leaders in health economics

2018 International Health Technology Assessment Fellowship Cohort

With India rolling out the one of the largest public health insurance initiatives in the world, it became more important than ever for government, university, and health care leaders to understand key aspects to health economics. Dr. Jitendra Sharma, Advisor on Health and Medical Technology to the Government of Andhara Pradesh invited UWSOP’s CHOICE Institute Director, Anirban Basu, to teach health economics as part of the annual International Fellowship Program on Health Technology Assessment (HTA) in Vishakhapatnam, India. The five-day workshop is hosted at the Andhra Pradesh Medtech Zone campus. The fellowship program aims to provide better understanding of Health Technology Assessment among government officials, health care program managers, innovators, professionals and health care providers.

The Honorable Health Minister Kamineni Srinivas, from the Government of Andhra Pradesh, recognized CHOICE Director Anirban Base

The fellowship program offers sessions by expert faculty in the subjects of systematic reviews, economic analysis and medical technology evaluations. Anirban teaches the health economics and economic evaluation components and serves as an advising member on the Health Insurance Commission for the Honorable Health Minister, Kamineni Srinivas, and advises the health ministry on state health insurance programs such as Aarogya Raksha, which is one of the few public health insurance targeting people above poverty line in India.

Part of the government’s 2018-19 budget presented last month, India’s new health care plan would offer 100 million families up to roughly $7,800 for coverage per year. Read more about the initiative’s specifics here.

Advance your career in patient-centered outcomes research that has a global impact at the University of Washington. Learn more about our Pharmaceutical Outcomes Research and Policy Graduate Programs in The CHOICE Institute at UWSOP.

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Barker-Haliski advances research in antiseizure therapies in patients with Alzheimer’s

When a project is moments away from completion, or a new question arises during the experiment, a little bit of extra funding can go a long way. This is the inspiration behind the ITHS Catalyst program. This pilot award is designed to provide investigators with “just-in-time” resources of up to $5,000. For Melissa, the ITHS Catalyst Award provided her the funds needed to extend her experiment just long enough to collect data that better reflected the clinically-relevant time period she was hoping to study.

Melissa Barker-Haliski, PhD, research assistant professor in the Department of Pharmacy conducts preclinical research in the evaluation and characterization of investigational therapies for epilepsy in special patient populations, including elderly patients. While there are many antiseizure drugs on the market for epilepsy, little information is available to compare the effectiveness of these therapies with older populations. Furthermore, researchers are starting to see that seizures and epilepsy are frequently present among those with Alzheimer’s disease. Melissa’s research aims to better understand this relationship so that one can investigate how antiseizure medications could affect the health of the Alzheimer’s disease patient population.

Preclinical antiseizure drug development is predominately conducted in rodent seizure and epilepsy models. Melissa studies the impact of seizures on a mouse model of familial early-onset Alzheimer’s disease. Human patients with familial early-onset Alzheimer’s disease begin to show neurodegenerative symptoms in mid-life (40- to 50-years-old). By extending her experiment a few months, Melissa was able to collect pilot data when the mice were of a physiological age that more closely reflects when symptoms of Alzheimer’s disease are likely to be show up in humans.

“We know that people with Alzheimer’s are having these seizures, but we don’t know how it effects their outcomes”
–Dr. Melissa Barker-Haliski, UW School of Pharmacy

With ITHS funds, she can take a closer look to engage this question by collecting essential data. “Without Catalyst funds, I would not have been able to age the animals to the time point that was most relevant to Alzheimer’s disease, she remarked.”

The experiment would have simply ended before the mice could reach that pivotal age. “This support has been very useful to the launch of my independent research.”

Melissa used this data to submit an application for further funding through the UW Royal Research Fund. Her newly-funded research will examine how chronic seizures in a similar cohort of mice with the Alzheimer’s disease-associated genetic mutation will impact cognition. She will demonstrate how chronic seizures affect the development of symptoms associated with Alzheimer’s disease. This data can then be compared to cognitive performance of age-matched mice who have not had chronic seizures. With an improved understanding of how seizures impact the evolution of Alzheimer’s disease, further study can be conducted on ways to treat the disease’s symptoms, and someday even slow its escalation.

The Catalyst award is intended to instigate new research directions and encourage further study in a given area. According to Dr. Barker-Haliski, this is precisely what has happened: “the initial ITHS funded project has been instrumental in furthering my work – I have been using this pilot data to submit grants left and right.” Working with ITHS has also enabled Melissa to deepen her capacity for collaboration with other departments on campus; by publishing this data, the research team can continue to pursue larger grants that will likely inform on the therapeutic management of seizures in Alzheimer’s disease.

Original story published on the Institute for Translational Health Sciences website and shared with here with permission.

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Our CHOICE PhD students continue to advance research to improve health outcomes

From all of us at CHOICE, we hope your year is off to a good start. Our PhD students have been busy since last year and we wanted to take the time to highlight a few of their key accomplishments.

Meng Li

Meng Li, a 5th year CHOICE PhD candidate, along with Kai Yeung (CHOICE Alum), and Josh Carlson (CHOICE Faculty) won Journal of Managed Care & Specialty Pharmacy’s (JMCP) Best Paper Award. The paper was submitted to JMCP as a Research Brief. They simulated the costs and outcomes of trastuzumab for the treatment of metastatic breast and gastric cancers, under the traditional indication-based pricing (IBP) framework using clinical trials data and the outcomes guarantee framework using data from observational studies.

They found that compared to a outcomes guarantee contract, a traditional IBP would be likely to produce an underpayment for metastatic breast cancer and overpayment for advanced gastric cancer. This research illustrated the potential of an outcomes guarantee framework to achieve prices aligned with real-world value for drugs with multiple indications.

Key Take Away: The policy implication for this research is that payers and manufacturers desiring to implement a value-based purchasing should consider outcomes guarantee contracts when there are analytic resources to support them.

The full paper can be found here

Mark Bounthavong

Mark Bounthavong, 5th year CHOICE PhD candidate, has been nationally recognized by the U.S. Department of Veterans Affairs and was invited to speak on the topic of improving medication safety for veterans. His goal is to educate providers using unbiased, noncommercial evidence so that they can provide the best care for Veterans.

Additionally, Mark and his team were awarded the American Society of Health-System Pharmacy Best Practice Award for their work on using trained clinical pharmacist to engage in academic detailing with Veterans Health Administration providers in order to augment their opioid and naloxone prescribing. The opioid epidemic has been called a national public health emergency by the U.S. President. Strategies to combat this has been varied, focusing on limiting the drug supply and identifying alternatives to pain management. My work focused on behavioral modification using educational outreach to target providers.

Simrun (Simi) Grewal

Since January 2017, CHOICE PhD student Simrun (Simi) Grewal has worked with UW’s Strategic Training, Analytics, and Research Center (START) as a research assistant with the Bill & Melinda Gates Foundation’s (BMGF) Integrated Portfolio Management (IPM) Team.

Recognizing the inherent trade-offs across investments to develop, introduce, and deliver healthcare solutions in low-and middle-income countries, IPM uses a systematic approach to estimate and compare the economic value, health impact, and risks of different vaccines and interventions. Through such a process, potential investments can be transparently prioritized to maximize total health impact across disease areas.

In addition to its internal function, IPM was designed to ultimately provide a public good in valuation modeling support to various communities facing global healthcare resources allocation decisions. As part of this aim, the team has collaborated with Gavi, the Vaccine Alliance. Founded in 2000, Gavi carries a mission to save children’s lives and protect people’s health by increasing equitable use of vaccines in lower-income countries. During the summer of 2017, the IPM team, including START student research assistants, conducted an analysis to assess the health impact of a typhoid conjugate vaccine (TCV) across countries eligible for Gavi support. The analysis contributed to information presented to the World Health Organization and the Gavi Board. In November 2017, Gavi announced its decision to provide $85 million between 2019-2020 to support to use of TCV in eligible countries

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

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New fellowship will advance thoughtful health care innovation in Washington state

Partnership between Washington Research Foundation and The CHOICE Institute at UWSOP creates opportunities for students and researchers at non-profit research institutions in Washington state

The CHOICE Institute at UWSOP is pleased to announce a partnership with the Washington Research Foundation (WRF) that will create four new fellowships per year designed to support non-profit research institutions and life science researchers.

Health economics and outcomes research (HEOR) is increasingly being used at earlier stages of product development for healthcare and life sciences to inform decision-making. While this expertise is commonly available at larger companies it may be inaccessible or unaffordable to researchers and technology developers within non-profit research institutions that have arguably the greatest need for that kind of service.

The WRF-HEOR Fellowship aims to address this gap by providing high quality health economic and outcomes research services to technology developers (scientists, engineers, inventors and entrepreneurs) at non-profit research institutions in Washington state while also providing a valuable training activity for graduate students at Washington state research institutions. On the UW side, the Fellowship will be led by Lotte Steuten of The CHOICE Institute at UWSOP and Fred Hutch. Dr. Steuten specializes in developing and applying quantitative (Bayesian) methods for estimating and comparing the expected health and economic benefits of new approaches and interventions in disease prevention and treatment, and prioritizing data collection to efficiently build the evidence for such promising new interventions.

“At the Washington Research Foundation, we see a clear need for reliable health economic and outcomes research to support the advanced technical and scientific work happening in Washington state, “ said Will Canestaro, Manager of Strategic Investments at WRF. “As healthcare costs continue to rise it is increasingly important for researchers to understand how their innovations translate into real-world value for patients and the healthcare system.”

Through this fellowship program at The CHOICE Institute, we aim to increase the number of decision-making tools available to researchers and technology developers. Ultimately this is democratizing this expertise and making it available across the state—all to the benefit of patients and the healthcare systems in Washington.
–Will Canestaro, Ph.D., Washington Research Foundation

Fellows and projects will be selected by a committee of faculty in The CHOICE Institute based on academic merit. Generally, awards will be made to second and higher year students in CHOICE. Fellows will have a CHOICE faculty mentor as well as an advisor from WRF.

The projects will evaluate a health technology (such as a diagnostic, therapeutic, or software), with preference for the most novel and high-impact technologies for patients or the healthcare system. Each fellow will create deliverables for the technology developer they are working for with the ultimate goal of providing meaningful insight that can improve their research and development process. Examples of project types include creating a cost effectiveness model to estimate the value of a technology in real-world practice, measuring the budget impact on the healthcare system of a technology, and measuring the human and economic burden of disease to patients and society.

“We appreciate the partnership developed with the Washington Research Foundation,” said Anirban Basu, Director of The CHOICE Institute. “Our student fellows will now have a wonderful opportunity to advance their research and training in a way that helps their local community and the state. We look forward with great anticipation to the first class of fellows and seeing what their research helps advance in health care.”

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

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Libin Xu and Brian Werth Receive Royalty Research Fund Award

Libin Xu, Assistant Professor of Medicinal Chemistry, and Brian Werth, Assistant Professor of Pharmacy, have received a Royalty Research Fund award of $38,175 for their project, “Targeting Altered Lipid Metabolism in Antibiotic-Resistant Staphylococcus Aureus.”

The RRF is funded from royalty and licensing fee income generated by the UW technology transfer program. It supports UW faculty seeking to advance new directions in research in disciplines for which external funding opportunities are minimal; for faculty who are junior in rank; and/or if the award might provide opportunities to increase applicants’ competitiveness for subsequent funding.

“Methicillin-resistant staphylococcus aureus (MRSA) strains are becoming more resistant to the cell-membrane targeting antimicrobials that help manage these infections,” said Dr. Xu. “This may be due to genetic mutations that lead to changes in the cell membranes of these MRSA strains.”

Dr. Xu and Dr. Werth, as co-Principal Investigators on the project, will test their hypothesis that changes in cell membranes contribute to the antimicrobial resistance, and that these changes can be modulated using small molecules of known lipid biosynthesis inhibitors to re-sensitize the mutated MRSA strains.

Congratulations to Drs. Xu and Werth on being funded for this exciting project!

To read more about the collaboration of Dr Xu and Dr Werth, click here.

Alumnus Glen Schumock, ’89, named Dean of the University of Illinois at Chicago College of Pharmacy

Glen Schumock, '89, The CHOICE Institute at UWSOP alumnus — Glen Schumock, ’89, The CHOICE Institute at UWSOP alumnus

Congratulations to University of Washington School of Pharmacy alumnus Glen Schumock, ’89, who will become Dean of the University of Illinois at Chicago College of Pharmacy! His appointment is effective January 1, 2018, pending approval by the University of Illinois Board of Trustees. Schumock earned his baccalaureate in pharmacy from Washington State University and received his doctor of pharmacy from the University of Washington, Seattle. He earned an MBA and a Ph.D. from UIC, and completed residency and fellowship training at the University of Washington, Seattle and at UIC. He has held clinical pharmacist and managerial positions in hospital pharmacies and is a licensed pharmacist in Illinois and Washington. Congratulations, Glen!

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

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Meet our Geriatric Pharmacy Preceptors: Karen Dawson

Karan Dawson, Clinical Associate Professor, Department of Pharmacy; Consulting Pharmacist, UW Pharmacy Cares
Following an internship at Valley Medical Center, Karan worked as a clinical pharmacist at the Veterans Affairs (VA) Medical Center in Seattle and completed a residency.

She returned to the UW for an MS in Pharmacy to explore teaching and research, which led to becoming the director of continuing pharmacy education. Given the changing needs of pharmacists to provide patient-centered care, she returned to the UW for a PhD in speech communication. She is one of three consulting pharmacists in an innovative, non-dispensing practice that serves retirement communities.

She has won three awards for innovative teaching, served in a series of elective offices for the American Association of Colleges of Pharmacy, continues to precept pharmacy clerkship students, and is a founding board member for the Center for Chronic Illness.

Her current research interests are in the areas of teaching effectiveness, the provision of non-dispensing pharmacy services, and application of mind/body/spirit/medicine techniques to enhance professional self-care and patient well-being. She gives talks to the general public and professional groups on topics ranging from drug therapy to self-care practices and on mind/body/medicine.

On a personal level, she has a meteorite fragment postulated to have fallen in 1516. Karan and her husband along with another couple own a house in Tuscany that they rent out, which in part explains her favorite cappuccino: “In Rome airport (Leonardo da Vinci / Fiumicino). Turn left immediately upon exit from baggage claim. The cafe is just beyond the pillar named ‘Meeting Point.’”

Are you interested in working with the top-rated faculty and studying geriatric pharmacy with preeminent student peers?

Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.

Veenstra weighs in on genetic testing in Science Magazine

DNA sample for gene sequencing at Debbie Nickerson Lab, University of Washington. Photo: Claire McLean, UW Medicine

The question about the benefits and pitfalls of genetic testing is discussed in, “Is health care ready for routing DNA screening? A massive new trial will find out” in Science Magazine. Pharmaceutical Outcomes Research and Policy faculty member and associate director, David Veenstra was interviewed for the story.

“In about 5 years I think we are going to have a very serious discussion about whether this is something that should be implemented in almost a public health sense, ” said Veenstra.

The main question being asked right now is whether or not widespread genomic screening will be a cost effective method of preventative medicine for patients. Many predict that this is the future of health care because it will better inform health care providers about the individual patient, in other words, personalized medicine at a genomic level. The cost of widespread genomic testing in the United States would fall mainly to insurance companies—and they will want to be sure that testing does not open the door to unsustainable health care costs, says Veenstra.

Known broadly as the MyCode Community Health Initiative and run by the Danville-based Geisinger Health System in Pennsylvania, the effort has so far sequenced the protein-coding DNA, or exomes, of more than 92,400 people. Geisinger asks each participant whether they are willing to be contacted if the sequencing reveals a DNA variant that puts them at risk for disease—and roughly 85% have agreed to be part of the experimental program called GenomeFIRST Return of Results. Veenstra studies the implications of using genomic information in health care and is working with Geisinger researchers to assess GenomeFIRST’s cost effectiveness.

Read the full article here

Advance your career in patient-centered outcomes research at the University of Washington.

Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

Stergachis co-edited maternal immunization roadmap for Gates Foundation & GAPPS

UWSOP Associate Dean Andy Stergachis co-edited the “Maternal Immunization Safety Monitoring in Low- and Middle-Income Countries: A Roadmap for Program Development” for the Bill & Melinda Gates Foundation and Global Alliance to Prevent Prematurity and Stillbirth, which was featured on the Gates Foundation blog, Impatient Optimists.

The first 28 days of life (the neonatal period) are the most vulnerable for a child’s survival. Worldwide, almost half of all deaths in children under five years old occur during the first 28 days of life. Despite progress in recent decades, neonatal mortality remains the highest in low- and middle-income countries (LMICs), and 99% of all neonatal deaths occur in LMICs.

The Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), with support from the Bill & Melinda Gates Foundation and input from a broad array of coauthors and stakeholders, developed a landmark report that summarizes the literature and existing systems for monitoring the safety of maternal immunizations in LMICs. The report includes an analysis of MNCH surveillance in LMICs, identifies gaps, and outlines a roadmap for program development and implementation of safety monitoring for maternal immunizations in LMICs. This landscape analysis was a catalytic process, demonstrating the breadth of efforts in this area and bringing together a range of organizations and stakeholders from industry, academia, regulatory agencies, governmental and nongovernmental organizations, WHO, UNICEF, and the maternal, newborn, and child health (MNCH) organizations to develop a cohesive strategy.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

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Bounthavong receives UWSOP Graduate Leadership Award

Andy Stergachis presents UWSOP Graduate Leadership Award to Mark Bounthavong

The UWSOP Graduate Student Leadership Award honors graduate students who have demonstrated outstanding leadership and service and have had a positive impact on the School of Pharmacy, UW, the Northwest community, scientific and/or professional community. This year, the award goes to three students: Mark Bounthavong, Ryan Seguin, and Elijah Weber.

Mark Bounthavong, PharmD, MPH, is a PhD student in the Pharmaceutical Outcomes, Research and Policy Program (PORPP) in the UWSOP’s Department of Pharmacy. He recently completed service as President of the UW Student Chapter of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). His doctoral dissertation chair, Associate Professor Beth Devine, PhD, PharmD, MBA and Director, Graduate Program, PORPP, writes, “Mark’s intellect, inquisitive nature, drive, genuine personal warmth, fundamental desire to help others and, of course, leadership skills are reasons that will make us all proud to have him as recipient of this award.” Dave Veenstra, PharmD, PhD, Professor and Associate Director of PORPP writes, “As a PORPP student, Mark serves as a role model for other students.”

Mark’s work with the National Academic Detailing Program in mental health illness demonstrates a strong commitment to caring for Veterans. Mark received his award at the Welcome Back Graduate Program Reception on October, 16th 2017.

Advance your career in patient-centered outcomes research at the University of Washington. Learn more about our Graduate Programs in Pharmaceutical Outcomes Research and Policy.

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Team finds no adverse risk to use of common antimalarials in first trimester

Women and their children await medical care at a clinic. Photo: Photo courtesy of Malaria in Pregnancy Consortium

UW and international researchers publish the most comprehensive international analysis on artemisinin combination antimalarials safety in pregnancy

Malaria is more common and severe in pregnant women, increasing their risk of miscarriage and other adverse outcomes. The adverse consequences of malaria in pregnancy require prompt, safe, and effective treatment. However, limited data on the safety of the most efficacious and widely used antimalarial medications, artemisinin combination therapies (ACTs), has prevented ACTs from being recommended in the first trimester except in life-saving circumstances. The World Health Organization currently recommends the use of ACTs in pregnant women in the 2^nd or 3^rd trimester.

An international collaboration led by first authors Stephanie Dellicour of the Liverpool School of Tropical Medicine, UK, and Esperança Sevene of the Manhiça Health Research Centre/Eduardo Mondlane University, Maputo, Mozambique, and senior author Andy Stergachis of University of Washington School of Pharmacy and School of Public Health released the largest meta-analysis of all observational studies-to-date showing there was no difference in the risk of miscarriage, still births or major birth defects associated with the use of artemisinins anytime during the first trimester, compared with quinine. The study, “First- trimester artemisinin derivatives and quinine treatments and the risk of adverse pregnancy outcomes in Africa and Asia: A meta-analysis of observational studies,” was published in PLoS Medicine and coordinated through the Malaria in Pregnancy Consortium, established in 2007 at the Liverpool School of Tropical Medicine to improve the control and prevention of malaria in pregnancy.

“This study is clearly significant and reflects many years of work in Thailand and Africa by a large group of scientists,” said Liverpool’s Professor Feiko ter Kuile, head of the Malaria in Pregnancy consortium. “We have been able to show that artemisinins, which we know to improve outcomes in malaria, are as safe to use in the first trimester as quinine, which is currently recommended in the first trimester, but needs to be taken 3 times per day for 7 days. Quinine is associated with transient side effects such a ringing in the ears and dizziness, leading women not to complete their treatment course and risking inadequately treating their malaria. The artemisinin-based combinations are more efficacious, much better tolerated and can be taken over three days.”

The team analyzed data from five studies involving 30,618 pregnancies: four studies from Zambia, Tanzania, Rwanda, Kenya, Mozambique, Burkina Faso, and one large study from the Thailand based Shoklo Malaria Research Unit. They examined the records of women who had taken artemisinins for malaria, including during the first trimester of pregnancy. In malaria endemic countries, many early pregnancies are advertently or inadvertently exposed to artemisinins because women are not aware they are pregnant or do not report an early pregnancy.

The team summarized all available safety data on the effect of artemisinin exposure in the first trimester and compared the risk of miscarriage, stillbirth, and major congenital anomaly for pregnancies treated with artemisinin, quinine, or no antimalarials in the first trimester.

Through their meta-analysis, they determined the risk of miscarriages, stillbirths, and major anomalies associated with first-trimester artemisinin treatment versus quinine. The results were then combined with summary effect estimates from the Shoklo Malaria Research Unit on the Thailand–Myanmar border.

They found no increase in the risk of miscarriage, stillbirth, or major birth defects associated with the use of artemisinins anytime during the first trimester compared with the use of quinine during the same gestational period. These findings suggest that the artemisinin class of antimalarials should be considered for treatment of malaria in the first trimester of pregnancy. The limited data on the risk of birth defects require further observational studies.

Limited safety data on the use of artemisinins in human pregnancies have historically prevented health authorities from recommending these therapies for malaria treatment in the first trimester, except in life-saving circumstances. It is possible that this study may result in a major change to recommended guidelines for the administration of artemisinins in the first trimester of pregnancy.

“Our results show that artemisinins can now be formally considered for first trimester treatment,” said Andy Stergachis, Professor of Pharmacy and Global Health, University of Washington. While there is more work to be done in terms of monitoring birth defects, the available evidence suggests that the benefits of using this class of antimalarial are likely to outweigh any adverse outcomes and could help save the lives and maintain the pregnancies of women when they are most vulnerable to malaria.”

This project was supported by the Malaria in Pregnancy (MiP) Consortium, which is funded through a grant from the Bill & Melinda Gates Foundation to the Liverpool School of Tropical Medicine. The Malaria in Pregnancy Consortium consists of over 40 partner institutions in 29 countries around the world, joined in the fight against malaria in pregnancy and committed to improving its control and treatment in Africa, Asia and Latin America. The Shoklo Malaria Research Unit is part of the Mahidol Oxford University Research Unit, supported by the Wellcome Trust of Great Britain.

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About Liverpool School of Tropical Medicine

The Liverpool School of Tropical Medicine (LSTM) is the world’s oldest centre of excellence in tropical medicine and international public health. It has been engaged in the fight against infectious, debilitating and disabling diseases since 1898 and continues that tradition today with a research portfolio in excess of well over £210 million and a teaching programme attracting students from over 65 countries. LSTM has been the international coordinating centre for the Malaria in Pregnancy (MiP) Consortium (https://www.mip.lstmed.ac.uk/) with over 40 research partners world-wide, established with a $30 million grant from the Bill and Melinda Gates Foundation and subsequent grants from European & Developing Countries Clinical Trials Partnership (EDCTP) and European Union. For more information please visit www.lstmed.ac.uk

About University of Washington School of Pharmacy

The UW School of Pharmacy is a global leader in pharmacy education, research and service, committed to providing a transformative learning experience in a collaborative and diverse environment focused on improving the health and well-being of the communities we serve. The UW School of Pharmacy is comprised of three departments: Medicinal Chemistry, Pharmaceutics, and Pharmacy, offering Ph.D., M.S., and PharmD degrees, post docs and certificate programs. The Department of Pharmacy leads in pharmacy education, research, professional and outreach initiatives, including the Pharmaceutical Outcomes Research & Policy Program (PORPP), which conducts research in pharmaceutical economics, drug safety and pharmaceutical policy. To study with researchers like Dr. Stergachis, click on the links for more information about our Graduate Programs in Medicinal Chemistry, Pharmaceutics, Pharmaceutical Outcomes Research and Policy, and Biomedical Regulatory Affairs.

About University of Washington School of Public Health

The UW School of Public Health, established in 1970, enrolls 1,500 students and has 270 primary and joint faculty members. Its mission is to create a world of healthy people in sustainable communities – locally, nationally and globally. Through its five departments, five interdisciplinary programs and more than 50 research centers, it carries out projects with partners in more than 130 countries.

About Shoklo Malaria Research Unit

The Shoklo Malaria Research Unit (SMRU) is a field station of the faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, and is part of the Mahidol-Oxford Research Unit supported by the Wellcome Trust, United Kingdom. The main objective of SMRU is to provide quality health care to the marginalized populations living on both sides of the Thai-Myanmar border in the Mae Sot area, Tak Province through the dual activities of research and humanitarian services, with an emphasis on maternal-child health and infectious diseases.

UWSOP, Era Living Partner for Patient-Centered Care

In 2016, we celebrated the the 30th class of UWSOP Plein Certificate in Geriatric Pharmacy graduates! — In 2016, we celebrated the 30th class of UWSOP Plein Certificate in Geriatric Pharmacy graduates! (Sarah Buterbaugh pictured 5th from the left.) Photo: Alex Levine

UW School of Pharmacy offers a novel approach to student training and patient care in Era Living residential communities. The program is a mutually beneficial one: in addition to their regular pharmacy services, residents receive supplemental medication expertise for which UW pharmacy faculty and students are well-known and student pharmacists have opportunities to enrich their training through supervised patient consultations and more. “As integrated members of the health care team, UW faculty practitioners and our registered nurses, social workers, and care staff are able to share valuable information centered around enhancing the health and well-being of our residents,” said Jacob Almo, Vice President of operations at Era Living.

The program benefits UW Pharmacy students by creating opportunities to work alongside faculty pharmacists. On a regular basis, students enhance their training by giving important presentations to residents on a range of topics including drug safety and how to prevent the flu, reduce insomnia, and manage diabetes, osteoporosis and more.

“I learned to see more than the medication list, but to think about how the patients live their lives and the factors that matter to them the most, including medication cost, feasibility, side effects, and tolerability.” –Sarah Buterbaugh, PharmD, ’16

By being on-site regularly and under faculty supervision, students are available to meet with residents. UW student pharmacist Sarah Buterbaugh helped a resident who had a host of prescriptions, including oral medications, inhalers, and topical products. Working with faculty pharmacist Jennifer Wilson Norton, Sarah helped organize and explain the medications, including what was mandatory, optional, and how best to store them. “The resident to this day, still keeps Sarah’s organization system,” notes Jennifer.

Era Living offers “a unique practice environment and a wonderful experience for students,” said Sarah. “The geriatric population brings both curiosity and concern in the questions they have and each preceptor had time to discuss with me both the therapeutic options as well as to emphasize considering the patient as a whole. I learned just as much from the patients as the information we delivered to them. This rotation emphasized to me that the pharmacy profession is not just about medications but more importantly is about providing patient-centered care.”

Advance your career as a pharmacist at the University of Washington. Learn more about our nationally and globally top-ranked PharmD Program.

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Common genetic disorder linked to increased death rate from cancer drug

Busulfan, a chemotherapy drug commonly used to prepare patients for bone marrow transplantation, is linked to a dramatically increased risk of death in people with a common genetic disorder. Photo by Robert Hood / Fred Hutch News Service — Busulfan, a chemotherapy drug commonly used to prepare patients for bone marrow transplantation, is linked to a dramatically increased risk of death in people with a common genetic disorder. *Photo by Robert Hood / Fred Hutch News Service*

Researchers recommend ‘caution’ when using the chemotherapy busulfan in patients with Gilbert’s syndrome

By Susan Keown, Staff Writer, Fred Hutch News Service, Fred Hutchinson Cancer Research Center

Research published Thursday shows that a common genetic disorder ― one that many people don’t even know they have ― is linked to a more than twofold increase in death rates among patients treated with a particular cancer drug.

Scientists estimate that between 3 percent and 10 percent of people worldwide have Gilbert’s syndrome, which alters the way the liver processes one of the byproducts that results from the body’s recycling of dead red blood cells. Gilbert’s typically causes no ill effects; in fact, it’s even been linked to long life and good health in the general population.

This study found, however, that what typically seems to be a Dr. Jekyll turns into a Mr. Hyde for patients who receive a chemotherapy drug called busulfan, which is commonly used as part of a chemotherapy regimen prior to bone marrow transplantation. Bone marrow transplantation is a standard therapy for people with serious blood disorders like advanced leukemia.

The research overturns decades of conventional wisdom in the transplant field about the importance of Gilbert’s [“zhil-BARE’s”] syndrome, said Dr. George McDonald, a lead researcher on the study.

“In the medical textbooks, it’s always said to be totally benign, nothing bad ever happens,” said McDonald, a clinical researcher at Fred Hutchinson Cancer Research Center. This study’s results “came out the total opposite of what I expected.”

This study is just the latest example of how variations in metabolism from patient to patient can have huge impacts on the toxicity or effectiveness of a drug treatment, McDonald said.

“People are born with certain hair color, certain skin color, certain eye color — and certain metabolizing enzymes. You can tell people’s hair color … But you can’t tell what their enzymes are,” he said. “Right now, we assume every human being is going to metabolize drugs in the exact same way. But we know that that’s not true.”

McDonald’s hope is that this study, an analysis of 20 years of data on several thousand patients who were transplanted at via the Fred Hutch/University of Washington Cancer Consortium, will swiftly be validated and implemented to save lives.

“Like all science, it needs to be replicated,” McDonald said. “If it’s replicated with the same dimensions of risk, it’s something that should be universally applied in practice.”

A surprising and mysterious result

Gilbert’s syndrome typically has no outward signs unless a person is under particular physical stress, when they can develop mild jaundice, tiredness or abdominal pain. It’s detected via a blood test that measures levels of bilirubin, the blood-cell-breakdown byproduct whose processing is affected by the genetic disorder. McDonald estimates that about half of people with Gilbert’s are unaware of it; most people have no reason to be.

This isn’t the first study to show that Gilbert’s syndrome can affect how a drug is processed, or metabolized, by the body. Over the last couple of decades, reports have come out about patients with Gilbert’s syndrome who’ve experienced toxic side effects after taking certain drugs that are metabolized by the same enzymes affected by the syndrome.

These reports began to make McDonald wonder about the chemotherapy drugs that patients receive to prepare their bodies for transplantation.

“I’m a big believer in what’s called evidence-based medicine,” McDonald said on a recent day in his office at Fred Hutch in Seattle, behind a desk thoroughly covered in scientific papers.

McDonald was in the middle of moving offices, and a giant canvas mail cart alongside his desk was two-thirds full with outdated textbooks, now destined for the trash, that he collected over his career, which has spanned more than four decades.

For many of those years, McDonald was one of just a handful of people whose research was focused on gastrointestinal and liver complications of transplantation.

With this study, McDonald said, “I just wanted to see if the advice we’d been giving to patients for 40 years really had a factual basis when it came to people getting very high-dose chemotherapy.”

He felt confident. All available evidence on these drugs indicated that they were not processed by the metabolic mechanisms affected by Gilbert’s syndrome. If anything, McDonald reasoned, patients with Gilbert’s syndrome would experience fewer toxic side effects from these chemotherapy drugs than everyone else: Because of Gilbert’s effects on bilirubin-processing enzymes, these people have a higher blood concentration than normal of the preprocessed form of bilirubin ― which just so happens to be an antioxidant, a substance that protects cells from damage. (This antioxidant effect, researchers suspect, could be the reason why people with Gilbert’s tend to live longer and have lower rates of cardiovascular and lung disease than the rest of us.)

To find the answer to his question, McDonald and colleagues turned to a massive database dubbed Gateway, a compendium of medical data from patients treated by Fred Hutch and its consortium partners over 30 years. (The patients had all previously consented for their information to be used anonymously in research.)

Statistician Dr. Ted Gooley of Fred Hutch crunched the numbers from almost 3,500 transplant patients seen between 1991 and 2011, including more than 200 patients the researchers identified as having Gilbert’s syndrome based on records of their blood test results.

What came out of their analysis is rare in science, McDonald said ― a result that is dramatically different from what the researchers expected going into the study. In the first 200 days after transplant, patients with Gilbert’s syndrome who also received busulfan prior to transplant were more than twice as likely to die of any cause than all other patients, and they were nearly three times as likely to die of a cause not related to disease relapse. Gilbert’s seemed to have no effect on the outcomes when any other type of chemotherapy was used.