“Great scientists and great surfers share a common trait. They don’t position themselves where the big wave is now; they position themselves where the next big wave is going to be. PORPP teaches students to read the patterns in scientific methods, to understand the history that built up behind the last big waves, and to prepare for the ride of your life when you finally catch the big one.” – Mitch Higashi, `01, GE Healthcare’s Chief Economist
PORPP: The Founding
A Blueprint for Program Development
The Pharmaceutical Outcomes Research and Policy Program (PORPP) began largely out of a response to student and workforce needs. In 1989, Andy Stergachis, the current Associate Dean for Research, Graduate Programs and New Initiatives, was recruited from Group Health’s Center for Health Studies by Dean Milo Gibaldi to join the then-Department of Pharmacy Practice. Stergachis was advising David H. Smith, a student looking to begin a Ph.D., when he had a “light bulb” moment that ultimately led to the founding of PORPP.
Smith knew he wanted to do his doctorate work in Pharmacy, but UW did not offer a Ph.D. in Pharmacy. In the end, Smith chose an unconventional route and created his own interdisciplinary graduate program of study. As the School’s first Ph.D. graduate in pharmacy outcomes research, Smith went on and has achieved national prominence as Senior Investigator at Kaiser Permanente Center for Health Research.
What stayed with Stergachis was the need for a formal Ph.D. program in Pharmacy. Gibaldi, who had long wanted a doctoral program in Pharmacy, was very supportive. And with that, Stergachis and others began to develop a plan.
In 1990, Stergachis was awarded the Burroughs Wellcome/American College of Preventive Medicine Scholar in Pharmacoepidemiology Award, a 5-year career development award. The funding from that award provided much-needed seed funding for salaries, curriculum development, and support for new visiting faculty and fellows to the burgeoning program, including epidemiologist Dr. Jackie Gardner and a newly-minted Ph.D. from UC Berkeley named Sean D. Sullivan.
Sullivan and Stergachis first met at an APhA meeting in Washington DC. Sullivan was looking forward to beginning his new position at Wolfson College at Oxford University. But fate (and Stergachis) had a different plan.
Stergachis presented Sullivan with the vision of a program the caliber of which had not been seen in outcomes research. Sullivan was intrigued. When Stergachis showed up—in person—at Berkeley a few weeks later, Sullivan said yes. “And then I had to write the most difficult letter of my professional career. After all, who says ‘no’ to Oxford?” said Sullivan. “But it changed my life.”
Stergachis reflected, “Sean was the catalyst to carry the vision of a Ph.D. program forward and to extend the nascent program into the field of pharmacoeconomics.” With that, Gardner and Sullivan joined a small group of existing UW Pharmacy faculty working in pharmaceutical outcomes and policy that included Dale Christensen and Bill Fassett.
The development of the new Pharmacy Ph.D. program then began in earnest.
The team began the appeal for external support by writing grants to study the safety and value of pharmaceuticals as well as testing the effectiveness of pharmaceutical care services. They sought national recognition to build program credibility. They offered workshops about pharmaceutical outcomes, pharmacoeconomics and drug safety, giving a multitude of presentations to establish a national identity. They sought funding to establish an endowment for graduate students, and began to gain attention and support from a few forward-thinking pharmaceutical companies, including Eli Lilly & Company and then Immunex Corporation.
By 1995, the team had attracted top scholars and built enough support and funding that the time was right to secure an official Program designation at the UW as the Pharmaceutical Outcomes Research and Policy Program in the Department of Pharmacy. The team submitted the proposal to the UW for PORPP and its new graduate program in 1995. By 1997, the first class of Ph.D. students began.
“Andy’s vision took a lot of insight into the future interest in outcomes and policy research. What he created was ahead of its time. The hallmark of our program is its proven impact on local and national policy.”—Sean D. Sullivan
PORPP: The Building
A Blueprint for Program Growth
Ask any of the four directors of PORPP, Stergachis, Sullivan, Lou Garrison, or Anirban Basu, and they will tell you that the success of the program is in its people: Find the best faculty, the best graduate students, the best post-docs, and the program will thrive.
New faculty were attracted to the nascent program, including former FDA scientist Tom Hazlet who began a certificate in Biomedical Regulatory Affairs (BRAMS) in 1998 that became a master’s degree program ten years later. With the foundation built, the reins were handed over to Sullivan who became the new director, ushering in a new period of growth for the start up program.
Within a couple of years, new faculty, including former post-docs Beth Devine and Dave Veenstra, joined. The program was accredited by the Graduate School. The Corporate Advisory Board (CAB), comprised of leaders in the pharmaceutical and managed care industries, had its inaugural meeting, creating an opportunity for researchers and leaders to share findings, discuss opportunities and industry needs.
Key partnerships were formed with other organizations including CHASE Alliance, Hutchinson Institute for Cancer Outcomes Research at Fred Hutch, Health Services, Group Health Research Institute, and Premera Blue Cross. These partnerships continue to provide extraordinary opportunities for collaborations, data sharing, student and faculty research, and joint and affiliate faculty appointments.
As partnerships grew, so did endowments and funding. In 2006, Lou and Fran Garrison established the PORPP Endowed Prize in Health Policy and Economics in honor of Lou’s parents, Lou Sr. and Marilyn. Initially funded anonymously, the Prize was designed to inspire students in PORPP.
After graduating, students became advocates and exemplars of the excellence for which PORPP has become known. Mitch Higashi, for example, led an initiative to establish the Health Technology Fund for PORPP, through a collaboration of pharmaceutical and health care firms in 2010. Two years later he and his wife, Mandy, established the Higashi Family Endowed Fund, a graduate and post-doctoral fellow travel fund within the PORPP program.
The Certificate in Health Economics and Outcomes Research, a distance-learning certificate offered through Professional and Continuing Education began in 2011. The program continues to thrive and is completely self-sustaining. As of last fall, over 120 students have been trained.
Garrison, Basu and Devine established one of the first Centers of Excellence in Comparative Effectiveness Research with funding from the PhRMA Foundation in 2011. The Center provides advanced training in research methods to PORPP and Health Services graduate students.
Under Sullivan’s visionary leadership, PORPP joined the Agency for Healthcare Research and Quality’s (AHRQ) Evidence-based Practice Center Initiative in 2012, partnering with investigators at Oregon Health & Science University and Spectrum Research of Tacoma, WA. First led by Sean and Jerry Jarvik of UW Medicine’s Department of Radiology, the current site co-Principal Investigators are Beth Devine and John Gore.
That same year, Andy and JoAnn Stergachis established the Stergachis Family Endowed Directorship, ensuring the program is led by a dynamic and internationally recognized director and that the legacy of providing each student with specialized training in outcomes research is strengthened and enhanced.
“Sean took the program to a new level and I think it’s phenomenal. He did a superb job of institutionalizing the elements of PORPP that continue to this day and into the future.”—Andy Stergachis
PORPP: Through the Eyes of a Post Doc
As early as 1999, PORPP had established a great reputation and Beth Devine sought a post-doc opportunity in the program. “I was drawn to the opportunity to work with Sean and Andy at UW and Lou [Garrison] who was then at Roche. The coursework of biostatistics, epidemiology, decision analysis, and health policy was exactly what I was looking for as a next step in my career.”
As with many PORPP students and post-docs, Beth benefited from the program’s outreach to industry, obtaining a fellowship that included a year of coursework and a year of applied research at Roche Pharmaceuticals. She studied the cost-effectiveness of interferon-ribavirin for the treatment of hepatitis C; completed a study of patients to elicit their preferences for diabetic neuropathy, and completed several systematic reviews that summarized the psychometric properties of patient-reported outcome instruments to assess treatment outcomes for a variety of disease states, including depression and sleep apnea.
Devine had such a positive experience as a post-doc that she wanted to return as a faculty member. “The program has grown in many ways,” she notes. “We have hired additional faculty. Our students continue to be shining stars, our projects are varied and interesting, and we have superb collaborations with colleagues both inside and external to the UW.”
PORPP: To the Future and Beyond
A Blueprint for Continued Impact
In 2014, Sullivan was appointed Dean of UW School of Pharmacy and a national search began for a new Stergachis Family Endowed Director for PORPP. In May 2015, the successful search concluded with the selection of Anirban Basu, Ph.D.
At the time, Basu was a Professor of Health Services and an Adjunct Professor of Pharmacy and Economics. He continues affiliations with Health Services and Economics and co-directs the Program in Health Economics and Outcome Methodology (PHEnOM), a joint program between Departments of Health Services and PORPP. “He is a well-established researcher and mentor,” said Lingtak-Neander Chan, Interim Chair for the Department of Pharmacy. “His work in comparative effectiveness and health economics research is internationally recognized.”
Shortly after his appointment, Basu, Veenstra, and Josh Carlson got word of their $3M grant, funded by the National Heart, Lung, and Blood Institute (NHLBI) of NIH. They will develop a comprehensive toolkit of pragmatic value of information approaches and the corresponding software that can readily be used by clinical researchers and funders to estimate the value of randomized clinical trials.
“Dr. Basu is an incredible, dynamic leader and one of the brightest minds in the field. He is just the right person to take PORPP to its next level of growth: continuing its stability by creating opportunities for our junior faculty, students, and post-docs; growing partnerships with industry; and informing public policy with world-class research.”—Sean Sullivan
The future of PORPP is bright and wide open, poised to address many global and national challenges: from continued opportunities to inform national policy, to creating research to support the implementation of the Affordable Care Act and triple aim health care, to guiding best practices with the increase in personalized medicines, to understanding how human behavior affects medication adherence and clinical results, to the rise of technology in healthcare, to growing the international platform and linking with the important work done in the Global Medicines Program. “There are so many career paths for our graduates. It’s more important than ever that they understand the global marketplace,” notes Stergachis.
“I feel very fortunate to be selected as the director of PORPP. I think so highly of the PORPP faculty and students. We are primed to make excellent strides in the coming years in the field, including and beyond pharmaceuticals. I am excited to work with the faculty and students and see what we can do together in the next five to ten years.”—Anirban Basu
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