Graduate pharmacoeconomic and outcomes research educational programs in colleges and schools of pharmacy: A five-year update

American Journal of Pharmaceutical Education, Spring 2000 by Jackson, Terrence R, Draugalis, JoLaine R

The purpose of this study was to reassess the graduate pharmacoeconomic and outcomes research educational program offerings nationwide, estimate enrollment and completion figures, and determine the placement of recent graduates. An eleven-item questionnaire was completed by one faculty member at the 41 U.S. schools and colleges of pharmacy housing a social and administrative sciences graduate program for a 100 percent response rate. In five years, numbers have increased from 92 participants at 18 institutions with 18 anticipated completions to 317 enrollees at 35 institutions with 86 expected completions for academic year 1998-1999. Fellows were most apt to secure an industry post upon program completion, MS graduates tended to continue their studies, and PhD graduates were most apt to accept a position either in the pharmaceutical industry or an academic institution. Of the six institutions without an existing program, three are currently developing or in the process of implementing fellowship programs. The increase in enrollment figures and in numbers of institutions offering programs would appear to indicate that the demand for these individuals has not yet been met.

INTRODUCTION There are increasing numbers of pharmacoeconomic and outcomes studies being conducted and published. The resultant exposure of pharmacoeconomic information provides a base from which formulary committee members, health practitioners, and public decision-makers may best determine the best use of scarce healthcare resources. While several sets of guidelines and standards have been developed to increase the consistency and validity of these assessments and reduce bias, the majority of them provide only general recommendations to the evolving discipline(1). Pharmacoeconomics has been defined as "the field of study that evaluates the behavior of individuals, firms, and markets relevant to the use of pharmaceutical products, services and programs, and which frequently focuses on the costs (inputs) and consequences (outcomes) of that use."(2) Outcomes research has been defined as "the collection and analysis of data on the use of health care products, procedures, services and programs, and the evaluation of the clinical, economic, quality of life, and patient satisfaction outcomes of that care, to determine the value of those products, procedures, services, and programs."(2)

Pharmaceutical companies have an economic incentive in demonstrating quality of life, economic, and clinical outcomes of their products and therefore have an interest in maintaining high standards for conducting pharmacoeconomic evaluations(3). Further, clinical trials are increasingly being performed in managed care settings; including both phase III trials with economic and health related quality of life components as well as phase IIIB/phase IV trials(4). One of the principal uses of pharmacoeconomics will be to influence managed care decision-making through the use of formulary and policy issues. Additionally, pharmacoeconomic and outcome studies are being used in the assessment of biotechnology drugs, therapeutic drug monitoring, and disease management(5-7). The heightened awareness of practical applications of pharmacoeconomic evaluations has led to the increased demand for the necessary experts and skilled professionals and subsequently the number of the academic programs that provide these graduates. Presently, the demand for such services exceeds the supply of qualified professionals in the area of pharmacoeconomics and the educational infrastructure may be inadequate to currently satisfy the demand(8). The number of institutions and enrollment figures for pharmacoeconomic programs housed in the nation's colleges and schools of pharmacy were last reported in 1994(9). As a follow-up to that study, a questionnaire was developed to reassess these pharmacoeconomic and outcomes research educational programs. The purpose of this paper is to present updated figures. The numbers and types of graduate and fellowship programs available, estimates of the number of individuals recently graduated from such programs, and placements of students and fellows upon completion of their programs will provide more information about the supply and demand for such graduates.

METHODS

An eleven item questionnaire was sent to one faculty member at 41 U.S. colleges and schools of pharmacy identified as having a graduate program in the social and administrative sciences by a roster maintained on the American Association of Colleges of Pharmacy web page. The first mailing was sent on February 22, 1999, with a follow-up mailing to non-respondents on April 1, 1999. Follow-up continued via telephone through June of 1999 until a 100 percent response rate was achieved. A definition of pharmacoeconomics (PE) and outcomes research (OR) per the ISPOR lexicon(2) was provided in the cover letter and on the survey instrument.

The first five items asked respondents about the existence of programs, full-time and part-time enrollment numbers, number of students completing programs in the first half of 1999, and number of students who completed the programs during the past five years. All five items asked about five categories of program type including MS, PhD, or fellowship (no degree component, with a MS component, or with a PhD component). Items six through nine asked respondents for information about placement, job title, and year of graduation for each of the five program categories for the previous five years. Item ten was concerned with sources of funding for fellowship positions and item eleven asked about any programs in development. Total enrollment numbers were completed for program type and institution. Dependent student t tests were performed to make longitudinal comparisons.