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.
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 changemakers,” 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.”
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.”
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.
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
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.”
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.”
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.”
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.”
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.
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.”
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 deci
sion 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
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.