PHARMACEUTICAL COSTS: ‘Drug Police’ in High Demand

      Hospitals and insurers are increasingly turning to pharmacoeconomists and pharmacoepidemiologists, who study the costs and benefits of drugs as well as prescription and patient usage patterns, Friday's Boston Globe reported. The paper profiles Brigham and Women's Hospital's use of such experts -- affectionately called the 'drug police' -- whose work "dovetail[s] perfectly with the philosophy of managed care" by maximizing the value of every dollar spent on pharmaceuticals while providing high-quality care. Harvard's Dr. Jerry Avorn, a pioneer in both "pharmaco" fields, uses empirical methods to determine the efficacy of drugs and goes to great lengths to publicize the results, which often contradict the claims of pharmaceutical marketing campaigns. In a study on the drug Darvon, for example, Avorn's discovery that the "costly pain killer ... worked no better than aspirin" led to savings amounting to double the cost of his experiment. Dr. Joseph Gerstein, medical director of Tufts Health Plan, describes Avorn as a "prophet" who is now "being given his due." But Avorn takes his newfound popularity with caution: He fears that insurers may see his work as an excuse to withhold coverage for effective but pricey drugs. In the end, however, Avorn believes his academic studies provide the medical community with a "rational conversation instead of a lot of arm waving" about who should receive what care (Pham, 3/5).