Harkness Project Title:    The Effect of Strategies Implemented within Medicaid on the Uptake on New Medicines

Mentor: Steve Soumerai, Sc.D., Harvard Medical School

Placement: Harvard Medical School

Biography at time of Fellowship: Elizabeth Roughhead, a 2003–04 Commonwealth Fund Harkness Fellow in Health Care Policy, is a senior lecturer at the School of Pharmaceutical, Molecular and Biomedical Sciences at the University of South Australia. Her research interests include public policy concerning medicines, rational drug use, pharmacoepidemiology and adverse drug events. She has had considerable involvement in developing and evaluating aspects of Australia’s national medicines policy, particularly concerning efforts to improve the quality of medicine use in Australia. She has been a member of the Australian Federal Government’s expert advisory committee on quality use of medicines, the Pharmaceutical Health And Rational use of Medicines (PHARM) committee and its evaluation committee.  She is also currently a member of Federal Government’s Drug Utilisation Sub-Committee of the Pharmaceutical Benefits Advisory Committee, which provides expert advice on drug utilization in Australia; and the Evaluation Working Group of MediConnect, which provides expert advice on the evaluation of MediConnect, a system promoting the development of a national electronic medication record.

Project: Roughead examined the impact of fail-first and prior authorization policies on uptake of COX II inhibitors post-market entry in the Medicaid markets of the U.S.  She used data on Cox II inhibitor and non-selective non-steroidal anti-inflammatory drug utilization for 49 state Medicaid programs from January 1996 to September 2003, and conducted an interrupted time-series analysis on the significance of different state policies pre- and post-implementation.

Career Activity Since Fellowship

• Australian Research Council Future Fellowship, 2009
• Associate Professor, School of Pharmacy and Medical Sciences, University of South Australia, 2005
• Australian Institute of Political Science Tall Poppy Award for South Australia, 2005
• QUM Award for The Veterans’ Medicines Advice and Therapeutics Education Services (Veterans’ MATES), Quality Use of Medicines Program, Department of Veterans’ Affairs, 2008

E-Mail: libby.roughead@unisa.edu.au

Harkness-Related Publications

Morden NE, Zerzan JT, Rue T, Heagerty PJ, Roughead E, Soumerai S, Ross-Degnan D, Sullivan SD. “Medicaid Prior Authorization and Controlled-Release Oxycodone,” Medical Care. (In press)

Kemp A, Roughead E, Preen DB, Glover J, Semmens J. “Determinants of self-reported medicine underuse due to cost: a comparison of seven countries.” J Health Services Research Policy 2010 Apr; 15(2):102-14.

Morgan S, Kennedy J, Boothe K, McMahon M, Watson D, Roughead E. “Toward an understanding of high performance pharmaceutical policy systems: a ‘triple-A’ framework and example analysis.” The Open Health Services and Policy Journal 2009; 2: 1-9

Hughes CM, Roughead E, Kerse N. “Beyond Regulation: International Strategies to Improve Use of Medicines for Older People in Long-Term Care,” Healthcare Policy, 2008; 3(3): 37-51.

Roughead EE, Lopert R, Sansom LN. "Prices for Innovative Pharmaceutical Products that Provide a Health Gain: A Comparison between Australia and the United States," Value in Health 2007.

Morgan SG, McMahon M, Mitton C, Roughead E, Kirk R, Kanavos P, Menon D. “Centralized Drug Review Processes In Australia, Canada, New Zealand, And The United Kingdom,” Health Affairs 2006; 25(2):337-347.

Zerzan JT, Morden NE, Soumerai S, Ross-Degnan D, Roughead E, Zhang F, Simoni-Wastila L, Sullivan SD. “Trends and Geographic Variation of Opiate Medication Use In State Medicaid Fee-For-Service Programs, 1996 to 2002,” Medical Care 2006; 44(11):1005-10.

Roughead EE, Zhang F, Ross-Degnan D, Soumerai S. “Differential Effect of Early or Late Implementation of Prior Authorization Policies On Use of Cox II Inhibitors,” Medical Care 2006; 44(4):378-382