June 4, 2009
For pharmacy students, breaking down complex drug has its rewards
Each medication on your health plan’s “approved list” is there, in part, because a pharmacist vouched for it.
When a new drug enters the market, pharmacists at each health plan thoroughly research the medication, the diseases it treats, its potential health impacts and its economic implications. They present an extensive overview of their findings and make recommendations to the health plan’s Pharmacy and Therapeutics (P&T) Committee. The committee then asks questions and determines whether to add the drug to its approved list.
It is a process aimed at improving human health and making pharmaceutical care more affordable and accessible.
Recently, four UW students tried their hand at this drug-review process. Jessica Chao, Erin Cutter, Shannon Duke and Ellen Smith, all third-year Pharm.D. candidates in the School of Pharmacy, participated in the Academy of Managed Care Pharmacy (AMCP) P&T Student Competition.
And in April, the UW team won first place nationally — defeating teams from pharmacy schools at the University of California-San Francisco, Drake University and the University of Maryland, among others.
Essentially, the competition simulated the “real world” P&T decision-making process. Students acted as the staff pharmacists — analyzing a drug, presenting their findings and making their recommendations to a mock committee at the AMCP annual meeting in Orlando, Fla.
All the teams were charged with analyzing the same drug. This year, it was Tysabri, a new medication that treats Multiple Sclerosis and Crohn’s disease (an inflammatory gastrointestinal disease).
“This was probably the most complex drug that has ever been analyzed in the competition,” said John Watkins, pharmacy manager for formulary development at Premera Blue Cross of Washington and a UW affiliate associate professor of pharmacy. Watkins was also a team adviser who played a key role in helping the students form an AMCP student chapter at UW.
“Tysabri is a biologic drug that treats two completely different, complex diseases — diseases that the students weren’t fully familiar with.”
So, prior to the competition, they set out to become familiar with those diseases and the drug. The group closely analyzed the drug’s official dossier — which included scientific information about the drug’s safety, efficacy and economic value compiled by the drug’s manufacturer.
They supplemented this information by searching medical literature for relevant articles, creating pharmaco-economic models (measurements of cost vs. benefit and overall economic value) and otherwise considering the drug’s benefits and drawbacks from all possible angles.
At the national competition, the students gave a half-hour presentation of their findings to a mock P&T committee and responded to detailed questions. The committee — which was also the judging panel — comprised three experts from various health plans.
Obviously, the UW team made a good impression.
“I think I can honestly say that in the time that I’ve been watching this competition that I’ve never seen a team do better than this group,” said Watkins, who has judged the competition in the past. He praised the UW pharmacy students for the extensive pharmaco-economic models they built, their level of scientific knowledge, and their overall teamwork and presentation skills.
This was the first year the UW entered the competition. Nineteen teams originally applied to the nationals after winning local chapter contests in January. Only eight teams made it to Orlando.
For winning first place, the students received a $2,500 scholarship to go to the UW School of Pharmacy.
According to UW team captain Jessica Chao, the competition was “an application of everything we learn in pharmacy school — medicinal chemistry, pharmacology, pharmaceutics, cost-effectiveness analysis and so on.”
It also gave Chao and her teammates a chance to experience how managed-care pharmacy works. Managed care pharmacy is a field in which practitioners focus on ensuring that patients receive the most cost-effective, appropriate and beneficial pharmaceutical care possible.
“Patients who receive the correct drug in the correct way achieve better health outcomes and improve quality of life,” said Chao.
She hopes for a career in managed care pharmacy after she graduates, in part, because of the far-reaching impact she can have.
“Managed care pharmacy is extremely important,” she said, “as every tiny decision you make in managed care will influence a large population of individuals.”