The 2005 Health Care Symposium focused on the rising costs of pharmaceuticals, the drivers behind these costs, and physicians’ roles in this aspect of health care. Modern pharmaceuticals offer innovative treatments for a broad range of diseases, but these advances come at a steep price. Americans spent $164 billion on prescription drugs in 2002, an increase of 15% from the previous year.
Why do Americans spend so much on prescription drugs? Potential factors that were considered included economic (the introduction of new drugs—whether “breakthrough”, “me-too products”, or safer and more effective versions of older drugs), demographic (aging population), social factors (“medicalization” of conditions like shyness), and pharmaceutical promotional/marketing efforts.
We thank those who join us on February 12, 2005 for the 9th Annual UCLA Health Care Symposium, "Pills, Profits and Politics: Drivers of Rising Drug Costs and Strategies for Maximizing Value."
Robert Dubois, M.D., Ph.D. is Senior Vice President and leads Cerner Health Insights, a research and consulting company with expertise in evidence based medicine, health economics, and health services research. Bobby has spent the past 15 years focused on balancing issues of risk, benefit, and cost for managed care, the pharmaceutical industry, and provider organizations. He has over 70 publications. Dr. Dubois received his A.B. from Harvard College, his M.D. from the Johns Hopkins School of Medicine, and his Ph.D. in Health Policy from the RAND Graduate School. Dr. Dubois is also an Associate Clinical Professor of Medicine at the UCLA School of Medicine.
Kevin Sharer was elected Amgen's chief executive officer in May 2000. Sharer is the third CEO in Amgen's history. He became the company's third chairman of the board in January 2001.
Sharer joined Amgen in October 1992 as president, chief operating officer and member of the board of directors.
Before joining Amgen, Sharer was executive vice president and president of the Business Markets Division at MCI Communications. Prior to MCI, he served in a variety of executive capacities at General Electric, and was a consultant for McKinsey & Company.
Sharer received a bachelor's degree in aeronautical engineering from the U.S. Naval Academy in 1970, a master's degree in aeronautical engineering from the U.S. Naval postgraduate school in 1971, and also earned a master's degree in business administration from the University of Pittsburgh in 1982. Sharer served on two nuclear attack submarines following graduation from Annapolis.
Sharer serves on the board of directors of 3M, Northrop Grumman, UNOCAL and the U.S. Naval Academy Foundation. He is chairman of the board of trustees of the Los Angeles County Museum of Natural History and a member of The Business Council.
Philip Lee, M.D., Ph.D. is Senior Scholar, Institute for Health Policy Studies and Professor Emeritus of Social Medicine, Department of Medicine, School of Medicine at the University of California, San Francisco.
He is also Consulting Professor in Human Biology, Stanford University where he teaches an undergraduate course on health policy and health care. Dr. Lee was Assistant Secretary for Health and Scientific Affairs in the Department of Health, Education, and Welfare from 1965 to 1969 and Assistant Secretary for Health, U.S. Department of Health and Human Services from 1993 to 1997. He has been a member of the UCSF faculty since 1969 and served as chancellor of UCSF from 1969 to 1972. Before going to Washington in 1993, Dr. Lee served as Director of the Institute for Health Policy Studies, which he founded with Lewis Butler, JD at the University of California, San Francisco (UCSF) in 1972. From July 1986 through February 1993 he served as Chair of the Physician Payment Review Commission (PPRC) established by the U.S. Congress. In 1989, the PPRC recommended the resource based fee schedule, and limits on balance billing adopted that year by Congress for the Medicare Program.
Dr. Lee has co-authored numerous books, including "Pills, Profits and Politics"; "Primary Care in a Specialized World"; "Exercise and Health"; "Pills and the Public Purse"; "Prescriptions for Death: the Drugging of the Third World"; "Drugs and the Elderly: Clinical, Social, and Policy Perspectives"; and "Bad Medicine". His current research is focused on diversity in medical education, where the primary focus is a case study of Stanford and UCSF medical schools since 1960. He has just completed a study of Medicare and prescription drugs. Dr. Lee has recently received a number of the most prestigious awards in the field of health, including the David Rogers Award from the Association of American Medical Colleges (1999), the Institute of Medicine's Gustav O. Lienhard award (2000), and the American Public Health Association's Sedgwick Medal (2000).
Stuart Schweitzer, Ph.D. is a Professor of Health Services at UCLA School of Public Health teaching courses in health economics, health system organization and financing, and comparative health systems.
Professor Schweitzer earned his Ph.D. in economics from the University of California, Berkeley in 1966. He has taught at Wayne State University and Georgetown University, as well as having been on the research staff of The Urban Institute and the National Institutes of Health. He has served on President Carter's Commission for a National Agenda for the Eighties, and has held visiting appointments at Oxford University, CREDES (Paris), ESSEC (Paris), and the Shanghai Medical University. After joining the faculty of UCLA School of Public Health in 1976, he has served as Chair of the Department of Health Service from 1990-1993 and as Vice-Chair from 2003-2004.
His research interests are in the areas of health policy, especially as they pertain to pharmaceuticals, gerontology, and the financing of health care. Dr. Schweitzer directed a 6-year assessment of health screening and promotion for the elderly, financed by the Health Care Financing Administration. He co-directs the UCLA Research Program in Pharmaceutical Economics and Policy, with Professors William Comanor and Michael Intriligator.
Gerald Levey, M.D. Vice Chancellor of medical sciences and Dean of the David Geffen School of Medicine at UCLA.
Dr. Gerald S. Levey, a nationally recognized leader in both academic medicine and private sector medical affairs, is vice chancellor of medical sciences and dean of the David Geffen School of Medicine and holds the academic rank of professor of medicine in the department of medicine. As vice chancellor of medical sciences at UCLA he oversees a diverse medical enterprise including the School of Medicine, UCLA Medical Center, and the UCLA Neuropspsychiatric Institute and Hospital.
Dr. Levey joined UCLA in September 1994, having previously served as senior vice president for medical and scientific affairs at Merck & Co., one of the world’s leading pharmaceutical companies. He has held major leadership positions throughout his career, including serving as chair of the department of medicine at the University of Pittsburgh School of Medicine from 1979-1991. He is past president of the Association of Professors of Medicine, was a member of the Board of Governors of the American Board of Internal Medicine and is a member of the Association of American Physicians. Dr. Levey is a member of the medical honorary society Alpha Omega Alpha, and is a recipient of the Distinguished Alumnus Award from the University of Medicine and Dentistry of New Jersey and received his Mastership from the American College of Physicians in 1997.
Dr. Levey is an internist and endocrinologist widely known for his research on the thyroid gland and the heart. He was named a Howard Hughes Medical Institute Investigator while at the University of Miami from 1971-1978. Dr. Levey has developed a particular interest in issues of the nation’s physician supply and the role of generalist physicians, and served as co-chair of the National Study of Internal Medicine Manpower from 1981-1991.
|8:15 a.m. - 9:00 a.m.||Registration and Breakfast|
|9:00 a.m. - 9:10 a.m.||
Dr. Gerald Levey, MD, Dean, David Geffen School of Medicine at UCLA
|9:10 a.m. - 10:20 a.m.||
Keynote Addresses“Drug spending: Too little? Too much? Or, just the right amount?”
Dr. Robert Dubois, Senior Vice President, Cerner Health Insight
“The Challenges of Innovation.”
Mr. Kevin Sharer, Chairman and CEO, Amgen Inc.
“Pills, Profits, and Politics: Thirty Years Later.”
Dr. Philip Lee, former US Assistant Secretary of Health and Human Services
|10:20 a.m. - 10:40 a.m.||Intermission|
|10:40 a.m. - 11:30 a.m.||
Moderator: Dr. Stuart Schweitzer, Professor of Health
|11:30 a.m. - 12:00 p.m.||
Interaction with Audience (Q&A)
|12:00 p.m. - 12:15 p.m.||Conclusion & Door Prizes|
|12:15 p.m. - 1:00 p.m.||Lunch|
Bruce Allen Chernof, MD, FACP
Currently serves as the Regional Medical Director for State Health Programs in Southern California at Health Net, California's largest network-model managed care plan. Dr. Chernof joined Health Net in 1997 to work on the development and implementation of Health Net's "Healthy Families" plan, California’s version of the Federal Children's HealthInsurance Program (CHIP) which provides low-cost health insurance for uninsured poor children. He is also responsible for Health Net’s Managed Medi-Caid Program in Los Angeles County, covering more than 500,000 lives. Dr. Chernof completed his residency and served as Chief Resident in Internal Medicine at the UCLA-San Fernando Valley Program. After residency, Dr. Chernof completed a Fellowship in Medical Education at the UCLA School of Medicine. He earned his medical degree from UCLA and completed his undergraduate work at Harvard University. Currently, Dr. Chernof is an Adjunct Associate Professor of Medicine at UCLA and serves as the Director of the MD/MBA and MD/MPH Programs. In 2002, the Geffen School of Medicine at UCLA recognized Dr. Chernof with Award for Excellence in Education for these innovative programs. Dr. Chernof has lectured widely on a variety of subjects including Total Quality Management, health services research on the underserved, and the role of learning within the doctor-patient relationship. He has had work published in a variety of journals including Medical Care, the Journal of General Internal Medicine, and The Joint Commission Journal on Quality Improvement.
Susan L. Ettner, Ph.D.
Professor in the Division of General Internal Medicine and Health Services Research in the UCLA Department of Medicine and in the Department of Health Services in the UCLA School of Public Health. Dr. Ettner obtained her Ph.D. in Economics at the Massachusetts Institute of Technology in 1991. She was on the faculty of Harvard Medical School in the Department of Health Care Policy prior to joining UCLA as a tenured Associate Professor in 1999. Her research interests include reciprocity in the relationship between health and labor market outcomes, mental health and substance abuse services, insurance markets and managed care, chronic disability, post-acute and long-term care. Dr. Ettner was the 2001 recipient of the Alice S. Hersch New Investigator Award by the Academy for Health Services Research and Health Policy, given each year to the outstanding new health services researcher in the country. Dr. Ettner's current research projects include analyses of the cost-effectiveness of a randomized, integrated patient-provider intervention to prevent harmful and hazardous alcohol use in the elderly; treatment patterns and their relationship to outcomes among managed behavioral health patients; the impact of provider reimbursement incentives on the quality of diabetes care in managed care settings; risk adjustment of behavioral health care costs in the VA and Medicare among dual enrollees; the cost-effectiveness of a self-care intervention for elderly minority patients with diabetes; predictors of health services and long-term care use among triply diagnosed HIV+ patients; longitudinal wage mobility among Californians; cost-effectiveness of a randomized, personalized motivational intervention aimed at reducing alcohol/drug use and psychological distress among orofacial injury patients who have alcohol/drug problems; the role of depression and medical comorbidity in work disability and the use of private disability insurance; the cost-effectiveness of a community-based intervention for Alzheimer's patients; a pilot study of provider financial incentives for improving the quality of depression care; and a policy evaluation of the Substance Abuse and Crime Prevention Act (SACPA) of 2000.
Stanley Korenman, M.D.
Professor of Medicine - Endocrinology and Associate Dean-Ethics. He performs research in research ethics, dealing the with professional norms of scientists. He teaches a course in the Responsible Conduct of Clinical Research and has been commissioned to write an E-text on the subject. He participated in an IOM study of research integrity attempting to finding ways of enhancing research integrity for individuals and institutions. In endocrinology he is well known as one of the few internist- reproductive endocrinologists, managing such problems in both men and women. He has written extensively on erectile dysfunction, polycystic ovarian disease, the menopause, and male reproductive function with aging. Dr. Korenman was a Westinghouse Science Talent Search finalist. He graduated summa cum laude from Princeton and comleted medical school at the Columbia College of P&S. He received further training at the Endocrinology branch of the National Cancer Institute where he became a senior investigator. He was Asst and Assoc Prof of Medicine at Harbor UCLA Med. Ctr, Chief of Endocrinology and Professor of Biochemistry at the University of Iowa, and Chair, Department of Medicine at the UCLA San Fernando Valley Program. At CHS he initiated and directed the Medical Scientist Training program for 21 years, directed the Division of Endocrinology and Metabolism, and developed the Research Subject Advocacy program of the General Clinical Research Center. He serves on the Medical Center Ethics Committee.
Neil H. Parker, M.D.
Senior Associate Dean for Student Affairs and Graduate Medical Education, David Geffen School of Medicine at UCLA; Associate Professor, Department of Medicine. Among his numerous responsibilities, Dr. Parker oversees medical student admissions, provides guidance for outreach services, assists in negotiation of affiliation agreements and regularly counsels medical students. Dr. Parker has shown his dedication to medical education through his chairmanship of the 1st year Foundations-Orientation course and the Medicine Subinternship elective for 4th years as well as serving as a co-chair for the 3rd year Clinical Foundations course. He has also taught medical students as a tutor for both the Clinical Applications of Basic Sciences and the Pathophysiology of Diseases Case Studies courses. From 1981-1995, he served as Associate Program Director for the Internal Medicine residency program before which he was an attending physician for residents and fellows in the Department of Medicine. Dr. Parker is hailed as one of UCLA' s best instructors and consistently receives the highest marks from medical student and resident evaluations. He has twice been honored with the Outstanding Fulltime Faculty Award from the Department of Medicine in addition to receiving the UCLA Medical Staff Service Award. Dr. Parker is a fellow of the American College of Physicians and is a member of the national honorary medical society, Alpha Omega Alpha. Dr. Parker received his M.D. degree cum laude from the State University of New York, Downstate in 1972 and joined the faculty at UCLA as Chief Resident in Medicine in 1977.
J. Thomas Rosenthal, M.D.
Associate Vice Chancellor, David Geffen School of Medicine at UCLA Dr. Rosenthal joined the faculty of UCLA School of Medicine in 1986 as Associate Professor of Urology and Director of Renal Transplantation. Under Dr. Rosenthal’s leadership, the Renal Transplant program tripled in size while maintaining the highest graft survival results in the country. Clinical research was developed as an important part of the program, culminating in the program’s receiving NIH funding for participation in the first NIH sponsored clinical trials in transplantation. In 1990, he was appointed Executive Vice Chairman of the Department of Surgery and Vice Chairman of the Medical Faculty Board. He was responsible for improvements in contracting for specialty services, development of the Department of Surgery practice plan, and for hospital-wide clinical pathway development. In 1995, Dr. Rosenthal was appointed Interim CEO of the UCLA Medical Group, and in 1996 was formally appointed by to be Vice Provost and Director of the Medical Group. As Director of the Medical Group, he provided oversaw development of managed care services, including contracting, quality management, clinical effectiveness, utilization management, and claims. In 1999, Dr. Rosenthal’s duties were expanded to include a role as Chief Medical Office of UCLA Medical Center. This position was created to improve coordination efforts of key services among the Medical Staff, Hospital Systems, and the Medical Group. In 2003, he moved from clinical enterprise to School of Medicine to become Associate Vice Chancellor responsible for a variety of School functions including affiliate relations and research integrity. He remains Professor of Urology and a member of the renal transplant team.
Stuart Schweitzer, Ph.D.
Professor of Health Services at UCLA School of Public Health teaching courses in health economics, health system organization and financing, and comparative health systems. Professor Schweitzer earned his Ph.D. in economics from the University of California, Berkeley in 1966. He has taught at Wayne State University and Georgetown University, as well as having been on the research staff of The Urban Institute and the National Institutes of Health. He has served on President Carter's Commission for a National Agenda for the Eighties, and has held visiting appointments at Oxford University, CREDES (Paris), ESSEC (Paris), and the Shanghai Medical University. After joining the faculty of UCLA School of Public Health in 1976, he has served as Chair of the Department of Health Service from 1990-1993 and as Vice-Chair from 2003-2004. His research interests are in the areas of health policy, especially as they pertain to pharmaceuticals, gerontology, and the financing of health care. Dr. Schweitzer directed a 6-year assessment of health screening and promotion for the elderly, financed by the Health Care Financing Administration. He co-directs the UCLA Research Program in Pharmaceutical Economics and Policy, with Professors William Comanor and Michael Intriligator.
Carl Stevens, M.D., MPH.
Associate Professor of Medicine at UCLA and an attending physician and Director of Quality and Process Improvement for the Department of Emergency Medicine at Harbor-UCLA Medical Center.
Sondra Vazirani, MD, MPH
Hospitalist in the VA Greater Los Angeles Health Care System and an Assistant Clinical Professor in the Division of General Internal Medicine/Health Services Research at the David Geffen School of Medicine at UCLA. Clinically, Dr. Vazirani serves as the Medical Director of the Preoperative Clinic and the Medicine Consult Service at the West Los Angeles VA, and also attends on the wards and in the ER. Administratively, Dr. Vazirani serves on the Residency Advisory Committee and the Pharmacy and Therapeutics Committee. Dr. Vazirani has a paper in press regarding a research study that compared the effectiveness of care management by a hospitalist/ nursepractitioner/ multidisciplinary care management team versus conventional approach for acutely ill general medicine inpatients. Dr. Vazirani additionally has been an instructor for seven years for an elective in the UCLA Medical School regarding Health Policy. She has been married ten years to an attorney and has a gorgeous two and a half year old girl.
The directors of the UCLA Health Care Symposium are all 2nd year medical students at the David Geffen School of Medicine at UCLA.
A native of Southern California, Jacob Chacko graduated from the University of Southern California with dual degrees in Biology and Gerontology and a minor in Health Policy & Management. He then earned an MSc in Economic & Social History at Oxford University. After his graduate studies, Jacob worked as consultant for McKinsey & Co., focusing on health care clients. He has many interests in the field of medicine, particularly national health policy. In his spare time he enjoys reading, traveling, running and spending time outdoors.
Originally from Birmingham, MI, Steve graduated from the University of Michigan with a B.S.E. degree in Materials Science and Engineering and a M.S.E. in Biomedical Engineering. He participated in research at Michigan and in industry for Corning Inc. and Johnson & Johnson. His research experience has involved materials engineering and molecular imaging with applications to photonics, biosensors, and hip arthroplasty. He has co-authored three articles in peer-reviewed scientific journals and is listed as a co-inventor on three pending US patents. Steve is currently pursuing MD and PhD degrees through UCLA’s Medical Scientist Training Program. His PhD will merge his interests in biomaterials and nanoscience, which he plans to combine with a clinical career in pediatrics.
Shira Lipton attended Stanford University, graduating in 2001 with a double major in Human Biology and Spanish Literature. As part of the Stanford-in-Washington program, Shira worked at the FDA in the Division of Drug Marketing, Advertising, and Communications, studying how prescription drug advertisements on broadcast media affect physician prescribing patterns and patient compliance. After graduation, Shira continued her health policy work at the University of California San Francisco’s Institute for Health Policy Studies. Shira plans to pursue a career that will combine her interests in both media and medicine.
Kim graduated in 2002 from Stanford University with a major in Human Biology and a minor in Spanish. She stayed in the Bay Area for the subsequent year, working as a teaching assistant at Stanford and as a contributor to the health policy nonprofit organization, Kaiser Family Foundation. She has pursued roles in international health, volunteering in medical clinics in Papua New Guinea and Mexico in the past two years. Now at UCLA, she is also particularly interested in endocrinology, radiation oncology, or physiatry. Outside of school, she enjoys running, hiking, and spending time with family and friends.
Originally from Virginia Beach, VA, Jeff attended Duke University where he majored in Chemistry and Biology and minored in Political Science. He graduated in 2003, and subsequently drove across the country to begin medical school. At UCLA, he enjoys tutoring, studying, dancing and designing (t-shirts and websites). Jeff is thankful to be in Los Angeles where he delights in the city’s diverse culture, cuisine, beautiful beach, weather and church. He hopes to remain in the area and pursue a career in oncology, psychiatry, or surgery.
Jamie graduated in 2002 from University of Michigan with a degree in political science. She is interested in too many aspects of medicine to have decided on a specialty as of yet. Outside of school she enjoys spending time with friends and family.
The 2005 HCS Assistant Directors are
Warren Chow, Susan Park, Trent Custis, Matt Frank, Caleb Ho, and Menna Seifu.
We would like to thank these organizations for sponsoring the 2005 Health Care Symposium.