Margolis

The Duke-Margolis Center for Health Policy announced the appointment of an external advisory board at a public launch on February 9 in Washington, D.C.

The event featured Duke University faculty engaged in health policy research and panel discussions focusing on the fast-changing health policy environment for healthcare transformation and high-value biomedical innovation. U.S. Sen. Richard Burr (R-NC) offered opening remarks.

Advisory board member Susan Dentzer, president and CEO, Network for Excellence in Health Innovation (NEHI), moderated a panel focused on healthcare transformation, which included Victor Dzau, president of the National Academy of Medicine. Advisory board members participating included David Brailer, managing partner, Health Evolution; David Feinberg, president and chief executive officer, Geisinger Health; Michael O. Leavitt, Leavitt Partners and former governor of Utah; and Debra L. Ness, president, National Partnership for Women & Families.

A panel on high-value biomedical innovation was chaired by advisory board member Peter Orszag, vice chairman of investment banking and global co-head of healthcare, Lazard, and included Joseph Jimenez, chief executive officer, Novartis; David P. King, chairman and chief executive officer, Laboratory Corporation of America; Jessica Mega, chief medical officer, Verily (formerly Google Life Sciences); and Dan Mendelson, president, Avalere Health.

Other advisory board appointees who could not attend the launch include Drew Altman, president and chief executive officer, Henry J. Kaiser Family Foundation; Tony Coles (M’86), founding investor, chairman and chief executive officer, Yumanity Therapeutics; and Joseph R. Swedish (G ’79), chairman, president and chief executive officer, Anthem Healthcare.

“We are pleased and honored to have recruited such a unique and distinguished group to help guide the Duke-Margolis Center’s mission of improving health and the value of health care in our communities and around the world,” said Dr. Mark McClellan, Margolis Professor and Director. “They have demonstrated leadership in making needed changes from a wide range of perspectives across the breadth of health care, biomedical research and population health. We appreciate their support for the Duke-Margolis approach to developing and analyzing new health policy ideas, and applying them in real-world settings, at a time when reform is both urgently needed and challenging to do effectively.”

During the event, speakers honored the vision and achievements of the center’s founder, Robert J. Margolis (M ’71), and his role in recruiting a top-notch advisory board and shaping the vision of the center. In October 2016, Duke University announced a $16.5 million gift from Margolis and his wife, Lisa, to create the center, which has offices in Durham, N.C., and Washington, D.C., where Gregory Daniel serves as deputy director and leads the biomedical innovation portfolio.

Originally posted on the Duke-Margolis Center for Health Policy website. Watch a video recording of the event.

In a special communication published today (Sept. 13) in the Journal of the American Medical Association, a panel has updated 20-year-old guidelines and recommendations for evaluating cost-effectiveness in health and medicine.

The updates build on the original work of the 1996 Panel on Cost-Effectiveness in Health and Medicine, originally convened by the U.S. Public Health Service. They are intended to guide decision-makers in using new methods for analyzing evidence, reporting standardized results, incorporating both health care system and societal perspectives, and weighing ethical issues in the use of cost-effectiveness analysis.

The panel was led by co-chairs Gillian D. Sanders, professor in the Duke Department of Medicine and a member of both the Duke Clinical Research Institute and the Duke-Margolis Center for Health Policy, and Peter J. Neumann, director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center. Neumann is also a professor of medicine at Tufts.

“Cost-effectiveness analysis can help inform decisions about how to apply new or existing medical tests, therapies and prevention techniques so that decision-makers use health care resources wisely,” said Sanders. “As health care costs continue to rise at unsustainable rates, these recommendations provide a framework for comparing the relative value of different health care interventions and help decision-makers across the spectrum from policymakers to patients sort through alternatives and decide what tests and treatments make sense.”

“During the 20 years since the original panel’s report, the field of cost-effectiveness analysis has advanced in important ways and the need to deliver health care efficiently has only grown,” said Neumann. “Updating the guidelines provides an opportunity to reflect on the evolution of cost-effectiveness analysis and to provide guidance for the next generation of practitioners and consumers.”

Primarily funded by grants from the Robert Wood Johnson Foundation and the Bill & Melinda Gates Foundation, the panel recommends several key changes to the guidelines, including:

• Broadening the scope of the Reference Cases, a standard set of methodology that should be followed to ensure quality analysis by creating comparable measurements.

• Measuring health effects in terms of quality-adjusted life years, a measure that includes both the quality and quantity of a person’s life.

• Including both costs reimbursed by third-party payers and those paid for out-of-pocket by patients in health care sector analyses.

• Using an “Impact Inventory” that lists the health and non-health effects of a health care intervention to ensure that all consequences are considered, including those to patients, caregivers, social services and others outside the health care sector. This tool also allows analysts to look at categories of impacts that may be most important to stakeholders.

• A reporting checklist and guidelines for transparency that includes assumptions in any analysis and the disclosure of potential conflicts of interest.

The panel also included Anirban Basu (University of Washington), Dan W. Brock (Harvard Medical School), David Feeny (McMaster University), Murray Krahn (University of Toronto), Karen M. Kuntz (University of Minnesota), David O. Meltzer (University of Chicago), Douglas K. Owens (VA Palo Alto Health Care System and Stanford University), Lisa A. Prosser (University of Michigan), Joshua A. Salomon (Harvard T.H. Chan School of Public Health), Mark J. Sculpher (University of York, UK), Thomas A. Trikalinos (Brown University), Louise B. Russell (Rutgers University), Joanna E. Siegel and Theodore G. Ganiats (University of California — San Diego School of Medicine).

Originally posted on the Duke-Margolis Center for Health Policy website

Duke University is launching a new health policy center whose goal is to develop ideas on health reform and move them into practical implementation, President Richard H. Brodhead announced Monday.

The center, founded with a $16.5 million gift from Duke medical school alumnus Robert J. Margolis and his wife Lisa, through the Robert and Lisa Margolis Family Foundation, will connect the intellectual resources at Duke with policymakers and policy analysts in the public and private sector.  Disciplines involved in the Duke-Robert J. Margolis, MD, Center for Health Policy will include business, biomedical research, clinical care, public policy, global health, law and other areas.

The center’s inaugural director will be Mark McClellan, one of the nation’s leaders in health policy and reform.  McClellan is a senior fellow at the Brookings Institution and director of the Health Care Innovation and Value Initiatives, and much of this work will be moving to the new Duke-Margolis Center.  Gregory Daniel, a Brookings fellow and leader of its biomedical innovation portfolio, will join McClellan and help direct the center’s Washington, D.C., office.

“Duke has a long-standing commitment to complex problem-solving in real-world settings, and deriving the highest value from American health care is a challenge perfectly suited to our interdisciplinary skills,” Brodhead said. “We are enormously grateful to Bob and Lisa Margolis for this gift, which will allow Duke to unify its expertise in medicine, business and policy to make advances in this field.

“We are also thrilled to have Mark McClellan join us as the center’s director. His experience in the evolving health care landscape is virtually unmatched, and colleagues across the university will welcome his leadership.”

The Duke-Margolis Center will be based at the Fuqua School of Business, with staff and offices in both Durham and at Duke’s center in Washington, D.C.  It will have participation from faculty and staff at Fuqua, Sanford School of Public Policy, School of Medicine, School of Law and other units, and will collaborate with experts and health care reformers from across the country and around the world.  The center’s activities will include serving as a hub for “translational” policy research and analysis — that is, for supporting the movement of promising ideas in health reform into the implementation of effective policy.

“This new initiative marks an important and transformative collaboration within Duke, bringing together our campus schools and Duke Medicine,” said Sally Kornbluth, Duke’s provost and Jo Rae Wright University Professor.  “The Duke-Margolis Center under the direction of Mark McClellan will be the focal point for faculty and students to test ideas, bring them forward to create change and to realize Duke’s full potential in a vital field.”

Added Eugene Washington, chancellor for health affairs and president and CEO of the Duke University Health System, “Since arriving at Duke, I have gained a keen appreciation of the tremendous portfolio of health-related programs arrayed across the university.  We are incredibly grateful and proud that the vision to draw on all the components through the Duke-Margolis Center is being made possible by one of the most distinguished graduates of our School of Medicine.”

Margolis, a 1971 graduate of the School of Medicine and house officer at Duke from 1970-72, is the retired managing partner and CEO of HealthCare Partners, a physician-owned and operated medical group, independent physician association and management services organization.

“While American health care is world class in many respects, there remain wide disparities in access, quality and beneficial use of resources,” Margolis said.  “Duke is uniquely positioned to rigorously study, research and evaluate new and best practices in the U.S. and abroad and advocate for public policies that promote equitable, efficient and high-quality care for all Americans.”

Margolis was a founder of HealthCare Partners’ predecessor, California Primary Physicians Medical Group, and currently sits on the board of directors of the Martin Luther King, Jr., Hospital in Los Angeles and the National Committee for Quality Assurance.  He previously chaired the California Association of Physician Groups, the California Hospital Medical Center, Los Angeles and the Council of Accountable Physician Practices.  He also held a fellowship in oncology at the National Cancer Institute.  In addition to his medical degree from Duke, Margolis earned an undergraduate degree from Rutgers University

McClellan, the new center’s director, will also be the Robert J. Margolis MD Professor of Business, Medicine and Health Policy.  A physician and economist, McClellan is a former administrator of the Centers for Medicare & Medicaid Services. He is also a former commissioner of the U.S. Food and Drug Administration (FDA), where he oversaw development of the Medicare prescription drug benefit, the FDA’s Critical Path Initiative and public-private initiatives on improving the quality of care and reducing its costs. McClellan previously served as a member of the President’s Council of Economic Advisers and senior director for health care policy at the White House, and was an associate professor of economics and medicine at Stanford University.

“I’ve had many opportunities to work with the faculty and staff at Duke, and I appreciate the university’s unique and diverse capacity to support health policy research and health policy reform,” McClellan said. “It is a tremendous privilege to work with the Duke-Margolis Center to make a difference in health care and health.”

McClellan chairs the National Academy of Medicine’s Leadership Consortium for Value and Science-Driven Health Care, co-chairs the guiding committee of the Health Care Payment Learning and Action Network, directs the Merkin Initiative on Payment Reform and Clinical Leadership, is a senior adviser on health policy for the Dell Medical School at the University of Texas at Austin, and is a research associate at the National Bureau of Economic Research.

He graduated from the University of Texas at Austin, then earned a medical degree  from the Harvard University–Massachusetts Institute of Technology (MIT) Division of Health Sciences and Technology, a Ph.D. in economics from MIT and a master of public administration from Harvard.  McClellan has been board-certified in internal medicine and a practicing internist during his career.

Daniel, the deputy director, focuses on developing policy solutions to improve development, access and evidence for pharmaceutical products and medical devices. He is also a senior adviser to the Reagan-Udall Foundation and was previously vice president of government and academic research at HealthCore, Inc.  Daniel is a registered pharmacist with a Ph.D. from the University of Arizona, and undergraduate and graduate degrees from The Ohio State University.

Originally published on Duke Today