Pharmacoeconomic fellowships: the need for outcome measures

Competencies for Professionals in Health Economics and Outcomes Research: The ISPOR Health Economics and Outcomes Research Competencies Framework

The need for Health Economics and Outcomes Research (HEOR) has expanded globally, fueling demand for professionals trained in the discipline. By leveraging the expertise and perspectives of its members, the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) established a set of competencies for HEOR professionals. The resulting 41 competencies were organized into 13 topic domains that collectively comprise the ISPOR Health Economics and Outcomes Research Competencies Framework. In this article, we explain the collaborative process used by the ISPOR Institutional Council and Faculty Advisor Council to identify and validate the framework. This process entailed expertise from the council members combined with natural language processing to examine competencies included in ISPOR Career Center HEOR job postings, qualitative input from a focused Institutional Council-Faculty Advisor Council workgroup, and quantitative input from 3 surveys of mutually exclusive member groups: a general member survey to assess importance and relevance of each competency, a faculty member survey to assess the extent to which HEOR graduate degree programs cover each of the competencies, and a student member survey to assess exposure to each of the competencies. Organization of the competencies into topic domains was achieved by engaging the Education Council, which applied a taxonomy consistent with ISPOR's educational programming. The resulting ISPOR Health Economics and Outcomes Research Competencies Framework has the important potential of serving as a tool to guide academic curricula, fellowships, and continuing education programs, and assessment of job candidates. As the HEOR field advances, so do the job types and the breadth of topics in which professionals must demonstrate competence. Future work will entail revisiting the competencies to ensure their currency and comprehensiveness, and tailoring the framework according to major specialty areas.

Health economics and outcomes research fellowship practices reviewed

The guidelines for health economics and outcomes research (HEOR) fellowship training programs devised by the American College of Clinical Pharmacy (ACCP) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) suggest that continuous improvements are made to ensure that postgraduate training through didactic and professional experiences prepare fellows for HEOR research careers. The HEOR Fellowship Program at Novartis Pharmaceuticals Corporation was standardized to enhance the fellows' HEOR research understanding and align professional skill sets with the ACCP-ISPOR Fellowship Program Guidelines. Based on feedback from an internal task force comprised of HEOR employees and current and former fellows, the HEOR Fellowship Program was normatively and qualitatively assessed to evaluate the current curricular program. Fellowship program activities were instituted to ensure that the suggested minimum level requirements established by the guidelines were being met. Research opportunities enabling fellows to work hand-in-hand with other fellows and HEOR professionals were emphasized. Curricular enhancements in research methodology and professional training and development, and materials for a structured journal club focusing on specific methodological and HEOR research topics were developed. A seminar series (e.g., creating SMART Goals, StrengthsFinder 2.0) and professional courses (e.g., ISPOR short courses, statistics.com) were included to enhance the fellows' short- and long-term professional experience. Additional program attributes include an online reference library developed to enrich the current research facilities and a Statistical Analysis Software training program. Continuously assessing and updating HEOR fellowship programs keeps programs up-to-date in the latest HEOR concepts and approaches used to evaluate health care, both professionally and educationally.

The Effect of Board-Imposed Changes on Maternal-Fetal Medicine Fellowships

OBJECTIVE

A 1996 survey of Maternal-Fetal Medicine fellows revealed that there was cause for serious concern over fellow experience. In 1997, Maternal-Fetal Medicine fellowships underwent significant changes, including a lengthening of the program and more stringent requirements for protected research performance. We investigated whether the changes imposed in Maternal-Fetal Medicine fellowships in 1997 have improved fellow experience.

METHODS

Fellows were identified through the Society of Maternal-Fetal Medicine. An identical survey to a 1996 survey using the Likert scale, ordinal- and categorical-scale questions were used. The results of the 1996 survey were compared with the results of the 2000 survey. chi2, Mann-Whitney U test, Fisher exact test, and analysis of variance were used where appropriate.

RESULTS

Sixty-five of 100 fellows returned the survey (return rate, 65%). Overall, there has been improvement in many areas of fellow experience. Significant changes include an increase in research time (7 months versus 18 months; P <.001), number of research projects (2.9 versus 4.3 projects/fellow; P <.001), fellows rating research time as adequate (66.4% versus 85.6%; P=.003), fellows receiving grant training (20.2% versus 37.1%; P=.012), 2 or more research presentations (36.2% versus 47.1%; P=.028), pursuit of a postgraduate degree (5.7% versus 32.9%; P <.001), presence of a mentor (68.1% versus 80.8%; P=.049), and the rating of mentorship as strong (59.4% versus 77.9%; P=.039). Of concern, 24.3% of current fellows did not believe they would receive their full-protected research time.

CONCLUSION

The changes imposed in Maternal-Fetal Medicine fellowships in 1997 appear to have had a positive impact on fellows' experience, especially the ability to perform and present research.

Education in pharmacoeconomics: an international multidisciplinary view

There is a global need for more training in pharmacoeconomics. Pharmacoeconomics is a relatively new discipline that draws from other more established disciplines; hence, multidisciplinary collaboration is recommended. Descriptions of opportunities for pharmacoeconomics education can be found in the literature and on websites, but research on the trends in pharmacoeconomics education is largely limited to training in US pharmacy schools. Although basic pharmacoeconomics concepts and methods can be standardised for different countries and cultures, specific applications and examples will differ by region. There are also different levels of educational need (awareness, application, conceptualisation) and different methods of receiving pharmacoeconomics education (short courses, internships, fellowships, graduate degrees). In order to assess educational goals, some educational programmes have moved toward the concept of developing and measuring 'learning outcomes', defined as the knowledge, skills and attitudes needed to fulfil the societal roles expected of the learner. This method can improve the standardisation of the educational process; however, there is still much work to be done in order to achieve real consensus on 'learning outcomes' in pharmacoeconomics.