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Elizabeth Roughead (fellow)

2003-04 Harkness Fellow Senior Lecturer School of Pharmaceutical, Molecular and Biomedical Sciences, University of South Australia

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 Roughead, 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

  • Professor, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Future Fellow and Director of the Quality Use of Medicines and Pharmacy Research Centre, 2013
  • Australian Research Council Future Fellowship, 2009
  • Quality Use of Medicines QUM Award for The Veterans’ Medicines Advice and Therapeutics Education Services (Veterans’ MATES), Quality Use of Medicines Program, Department of Veterans’ Affairs, 2008
  • 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


    Current Position: Professor, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Director and Future Fellow, Quality Use of Medicines and Pharmacy Research Centre, 2013 (Updated 1/2014)


    E-Mail: [email protected]

    Selected Publications:

    Kalisch Ellett LM, Pratt NL, Ramsay EN, Barratt JD, Roughead EE. Multiple Anticholinergic Medication Use and Risk of Hospital Admission for Confusion or Dementia. J Am Geriatr Soc. 2014 Oct 3.

    Vitry AI, Nguyen TA, Ramsay EN, Caughey GE, Gilbert AL, Shakib S, Ryan P,Esterman A, McDermott RA, Roughead EE. General practitioner management plans delaying time to next potentially preventable hospitalization for patients with heart failure. Intern Med J. 2014 Jun 18.

    Pratt NL, Ilomäki J, Raymond C, Roughead EE. The performance of sequence symmetry analysis as a tool for post-market surveillance of newly marketed medicines: a simulation study. BMC Med Res Methodol. 2014 May 15;14:66.

    Pratt NL, Ramsay EN, Kalisch Ellett LM, Nguyen TA, Barratt JD, Roughead EE.Association between use of multiple psychoactive medicines and hospitalization for falls: retrospective analysis of a large healthcare claim database. Drug Saf.  2014 Jul;37(7):529-35.

    Kalisch Ellett LM, Pratt NL, Barratt JD, Rowett D, Roughead EE. Risk of medication-associated initiation of oxybutynin in elderly men and women. J Am Geriatr Soc. 2014 Apr;62(4):690-5.

    Nguyen TA, Knight R, Roughead EE, Brooks G, Mant A. Policy options for pharmaceutical pricing and purchasing: issues for low- and middle-income countries. Health Policy Plan 2014 Jan 13.


    Roughead EE, Kalisch Ellett LM, Ramsay EN, Pratt NL, Barratt JD, LeBlanc VT, Ryan P, Peck R, Killer G, Gilbert AL. Bridging evidence-practice gaps: improving  use of medicines in elderly Australian veterans. BMC Health Serv Res 2013 Dec 12;13:514.

    Kemp A, Preen DB, Saunders C, Boyle F, Bulsara M, Holman CD, Malacova E, Roughead EE. Women commencing anastrozole, letrozole or tamoxifen for early breast cancer: the impact of comorbidity and demographics on initial choice. PLoS One 2014 Jan 2;9(1):e84835.

    Gadzhanova S, Bell JS, Roughead EE. What analgesics do older people use prior  to initiating oxycodone for non-cancer pain? a retrospective database study. Drugs Aging 2013 Nov;30(11):921-6.

    Gadzhanova SV, Roughead EE, Bartlett MJ. Improving cardiovascular disease management in Australia: NPS MedicineWise. Med J Aust 2013 Aug 5;199(3):192-5.

    Ramsay EN, Pratt NL, Ryan P, Roughead EE. Proton pump inhibitors and the risk  of pneumonia: a comparison of cohort and self-controlled case series designs. BMC Med Res Methodol 2013 Jun 24;13(1):82.

    Caughey GE, Preiss AK, Vitry AI, Gilbert AL, Roughead EE. Comorbid diabetes and COPD: impact of corticosteroid use on diabetes complications. Diabetes Care  2013 Oct;36(10):3009-14.

    Wahab IA, Pratt NL, Kalisch LM, Roughead EE. The detection of adverse events in randomized clinical trials: can we really say new medicines are safe? Curr Drug Saf 2013 Apr;8(2):104-13. PubMed PMID: 23713541.

    Pratt N, Andersen M, Bergman U, Choi NK, Gerhard T, Huang C, Kimura M, Kimura  T, Kubota K, Lai EC, Ooba N, Osby U, Park BJ, Sato T, Shin JY, Sundström A, Yang  YH, Roughead EE. Multi-country rapid adverse drug event assessment: the Asian Pharmacoepidemiology Network (AsPEN) antipsychotic and acute hyperglycaemia study. Pharmacoepidemiol Drug Saf 2013 Sep;22(9):915-24.

    Caughey GE, Preiss AK, Vitry AI, Gilbert AL, Ryan P, Shakib S, Esterman A, McDermott RA, Roughead EE. Does antidepressant medication use affect persistence with diabetes medicines? Pharmacoepidemiol Drug Saf 2013 Jun;22(6):615-22.

    Kemp A, Preen DB, Saunders C, Holman CD, Bulsara M, Rogers K, Roughead EE. Ascertaining invasive breast cancer cases; the validity of administrative and self-reported data sources in Australia. BMC Med Res Methodol 2013 Feb 11;13:17.

    Kemp A, Preen DB, Glover J, Semmens J, Roughead EE. Impact of cost of medicines for chronic conditions on low income households in Australia. J Health  Serv Res Policy 2013 Jan;18(1):21-7.

    Kemp A, Glover J, Preen DB, Bulsara M, Semmens J, Roughead EE. From the city  to the bush: increases in patient co-payments for medicines have impacted on medicine use across Australia. Aust Health Rev 2013 Feb;37(1):4-10.

    Ostini R, Roughead EE, Kirkpatrick CM, Monteith GR, Tett SE. Quality Use of Medicines--medication safety issues in naming; look-alike, sound-alike medicine names. Int J Pharm Pract 2012 Dec;20(6):349-57.

    Vitry AI, Roughead EE, Ramsay EN, Ryan P, Caughey GE, Esterman A, Shakib S, Gilbert AL, McDermott R. Chronic disease management: does the disease affect likelihood of care planning? Aust Health Rev 2012 Nov;36(4):419-23.

    Pratt N, Roughead EE, Salter A, Ryan P. Choice of observational study design  impacts on measurement of antipsychotic risks in the elderly: a systematic review. BMC Med Res Methodol 2012 Jun 8;12:72. Review.

    Kalisch LM, Caughey GE, Barratt JD, Ramsay EN, Killer G, Gilbert AL, Roughead EE. Prevalence of preventable medication-related hospitalizations in Australia: an opportunity to reduce harm. Int J Qual Health Care 2012 Jun;24(3):239-49.

    Gilbert AL, Caughey GE, Vitry AI, Clark A, Ryan P, McDermott RA, Shakib S, Luszcz MA, Esterman A, Roughead EE. Ageing well: improving the management of patients with multiple chronic health problems. Australas J Ageing 2011 Oct;30 Suppl 2:32-7..

    Vitry AI, Roughead EE, Ramsay EN, Preiss AK, Ryan P, Gilbert AL, Caughey GE, Shakib S, Esterman A, Zhang Y, McDermott RA. Major bleeding risk associated with  warfarin and co-medications in the elderly population. Pharmacoepidemiol Drug Saf 2011 Oct;20(10):1057-63.

    Ramsay EN, Roughead EE, Ewald B, Pratt NL, Ryan P. A self-controlled case series to assess the effectiveness of beta blockers for heart failure in reducing hospitalisations in the elderly. BMC Med Res Methodol 2011 Jul 18;11:106.

    Kemp A, Preen DB, Glover J, Semmens J, Roughead EE. How much do we spend on prescription medicines? Out-of-pocket costs for patients in Australia and other OECD countries. Aust Health Rev 2011 Aug;35(3):341-9.

    Caughey GE, Roughead EE, Shakib S, Vitry AI, Gilbert AL. Co-morbidity and potential treatment conflicts in elderly heart failure patients: a retrospective, cross-sectional study of administrative claims data. Drugs Aging 2011 Jul 1;28(7):575-81.

    Pratt N, Roughead E, Salter A, Ryan P. Factors associated with choice of antipsychotic treatment in elderly veterans: potential confounders for observational studies. Aust N Z J Public Health 2010 Dec;34(6):589-93.

    Othman N, Vitry AI, Roughead EE, Ismail SB, Omar K. Medicines information provided by pharmaceutical representatives: a comparative study in Australia and  Malaysia. BMC Public Health 2010 Nov 30;10:743.

    Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, Killer G, Gilbert AL. Collaborative home medicines review delays time to next hospitalization for warfarin associated bleeding in Australian war veterans. J Clin Pharm Ther 2011  Feb;36(1):27-32.

    Zhang Y, Vitry A, Caughey G, Roughead EE, Ryan P, Gilbert A, Shakib S, McDermott R. The association between co-morbidity and the use of antidiabetics or adjunctive cardiovascular medicines in Australian veterans with diabetes. Diabetes Res Clin Pract 2011 Jan;91(1):115-20.

    Roughead EE, Kalisch LM, Ramsay EN, Ryan P, Gilbert AL. Use of health services and medicines amongst Australian war veterans: a comparison of young elderly, near centenarians and centenarians. BMC Geriatr 2010 Nov 4;10:83.

    Othman N, Vitry AI, Roughead EE. Quality of claims, references and the presentation of risk results in medical journal advertising: a comparative study  in Australia, Malaysia and the United States. BMC Public Health 2010 May 29;10:294.

    Caughey GE, Roughead EE, Shakib S, McDermott RA, Vitry AI, Gilbert AL. Comorbidity of chronic disease and potential treatment conflicts in older people  dispensed antidepressants. Age Ageing 2010 Jul;39(4):488-94.

    Kemp A, Roughead E, Preen D, Glover J, Semmens J. Determinants of self-reported medicine underuse due to cost: a comparison of seven countries. J Health Serv Res Policy 2010 Apr;15(2):106-14

    Othman N, Vitry AI, Roughead EE. Medicines information in medical journal advertising in Australia, Malaysia and the United States: A comparative cross-sectional study. South Med Rev 2010 Feb;3(1):11-8. Epub 2010 Feb 15.

    Caughey GE, Ramsay EN, Vitry AI, Gilbert AL, Luszcz MA, Ryan P, Roughead EE. Comorbid chronic diseases, discordant impact on mortality in older people: a 14-year longitudinal population study. J Epidemiol Community Health 2010 Dec;64(12):1036-42.

    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):106-14. Epub 2010 Mar 4


    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