John O'Brien, MPH 2006
As a pharmacist working in the medical affairs department of a pharmaceutical manufacturer, a senior government official once told me “I don’t have a problem with new drugs. I just don’t think we use old drugs well enough.” My application statement to the Bloomberg School described my frustration about spending millions of dollars launching the 7th blood pressure drug in its class without changing the behavior of the two-thirds of hypertensive Americans who aren’t at their blood pressure goal. My goal was to combine industry interests with government programs to achieve the School of Public Health’s mission of “protecting health and saving lives – millions at a time.”
The Health Policy and Management curriculum provided helped me transition from medical affairs to government affairs, and ultimately become Senior Director of State Policy for the Pharmaceutical Research and Manufacturers of America (PhRMA). Using skills gained in the MPH core curriculum, I designed a Medicare Part D education and enrollment program funded by PhRMA, implemented by pharmacists and pharmacy students, and recognized by the Centers for Medicare and Medicaid Services. This led to several publications for legislators and policymakers, continuing education websites and DVDs, and a podium presentation with former Senator John Breaux following a speech by President George W. Bush. It also served as the basis for my MPH capstone, “State and Federal Interaction in the Implementation of Medicare Prescription Drug Coverage.” As an MPH student, I had served as a bridge between health professionals, policymakers, and the public in the modernization of Medicare, and helped 91% of America’s seniors obtain affordable prescription drug coverage.
As an MPH graduate and industry consultant, however, I recognized improving the affordability and access of prescription drugs didn’t necessarily improve their use. We were still wasting $290 billion each year on medication non-adherence, improper medication use remained a leading cause of preventable Medicare re-hospitalizations, and the cost of prescription drugs precluded their value. The Agency for Healthcare Research and Quality had begun to describe medication non-adherence as America’s newest drug problem, and all health care stakeholders had begun to recognize the important role of pharmacists helping patients get well, stay healthy, and save money. This led me to join the faculty of the new College of Notre Dame of Maryland School of Pharmacy, and help build the curriculum for this year’s inaugural class. It also provided the opportunity to serve as a Congressional Fellow for a member of the Senate Health, Education, Labor & Pensions Committee, and work with committee staff focused on making better medication use a component of delivery system reform. Our students benefit from my training in public health, and my experiences working with policymakers and the private sector, learning both the patient-centered aspects of pharmacy practice and the importance of population-based medication use to public health. My proximity to and relationship with the Bloomberg School of Public Health not only challenges me to remember what I learned as a student, but to be innovative in my research, teaching, and service to the community, including working with the media to explain better medication use. There is much work to be done integrating public health into pharmacy education and pharmacist practice, but if the past is prologue, my MPH will allow me to help build that bridge, too.
John O'Brien, PharmD, MPH currently holds the position of Assistant Professor of Clinical and Administrative Sciences at the College of Notre Dame of Maryland School of Pharmacy