Papers by Gregory Wellman
Journal of Pharmaceutical Marketing & Management, Jan 1, 2007
Choice-based conjoint analysis was used to construct and analyze multiple panels of drug products... more Choice-based conjoint analysis was used to construct and analyze multiple panels of drug products from which a sample of Midwestern physicians were asked to choose. The panels were varied on the drug attributes of brand name, efficacy, frequency of administration, side effects, and patient out-of-pocket expense based on prescription benefit program reimbursement. An acute medication (antibiotic in the treatment of community-acquired pneumonia) and a chronic medication (antidepressant) were simulated for physicians. For both types of agents, patient out-of-pocket expense was the most important attribute, followed by slightly different arrangements of frequency of administration, effectiveness, and side effects, which were statistically significant.
Research in Social & Administrative Pharmacy, Jan 1, 2008
BACKGROUND:Consumers face an array of multiattribute prescription benefit insurance programs that... more BACKGROUND:Consumers face an array of multiattribute prescription benefit insurance programs that include different access points (retail, supermarket, Internet, etc) and levels of pharmacist interaction (including medication therapy management services [MTMSs]). Because of this, there is a need for more sophisticated information to drive prescription benefit plan design.
OBJECTIVES:A pilot study to determine if choice-based conjoint (CBC) analysis with hierarchical Bayes (HB) estimation for individual level part-worths could provide a stable model for attribute preferences for prescription benefit insurance; to pilot test the addition of MTMSs to a prescription benefit management model; and to pilot and compare logit-based utility estimates to HB estimations in a conjoint market simulator.
METHODS:A mail-based survey was conducted using a random sample of 1500 residents of the United States. A CBC analysis instrument was developed to provide a single-stated choice from a selection of different prescription benefit plans. Choice tasks were varied based on the attributes: co-payment, pharmacy access, formulary, level of pharmacist interaction including MTMSs and monthly premium. Analysis included logit-based and HB estimation for utilities, and preference share market simulation testing.
RESULTS:The utility estimations from HB analysis were consistent with those seen in the logit-based analysis. A goodness of fit of 83% (root likelihood) was achieved in the HB utility estimations with only 4 choice tasks per respondents and the inclusion of MTM-like services. There was convergence on preference shares from the market simulation between the 2 estimation methods.
CONCLUSIONS:The use of CBC analysis with HB estimation provided utilities similar to those estimated using aggregated logit-based methods, with the added benefit of respondent specific part-worth scores for each attribute level. A larger sample, changes in the instrument design, more panels (tasks) per respondent, and selection of conjoint methods may allow for more predictive information from market simulators.
The purpose of this study was to examine the impact that proctored versus un-proctored testing wo... more The purpose of this study was to examine the impact that proctored versus un-proctored testing would have on learning for an on-line content module; and examine the relationship between LASSI variables and learning. A randomized, pre-test/post-test
control group design was employed. College students in a pharmacy curriculum, were randomized to two groups utilizing asynchronous, on-line content with a medical terminology module. Group A utilized proctored, on-line testing, while Group B utilized un-proctored on-line testing. Both were given a pre-test and post-test on medical terminology at the beginning and end of a sixteen week semester. The Learning and Study Strategies Inventory was administered to all students. On-line module delivery paired with proctored testing was more effective in promoting learning when compared to online module delivery paired with un-proctored testing. The constructs: anxiety, selftesting, attitude/interest and motivation were significant in predicting learning for proctored students. No significant model emerged for un-proctored students.
The purpose of this study was to evaluate the impact of proctored versus un-proctored testing on ... more The purpose of this study was to evaluate the impact of proctored versus un-proctored testing on practice time and learning for a self-study, online course in medical terminology. Participants included 120 college students in a pharmacy curriculum. Subjects were randomized to one of three groups utilizing textbook with proctored assessment, online instruction with proctored assessment, or online instruction with un-proctored assessment. A pre-test and post-test was administered to all three groups to evaluate learning. Content page “hits” and practice quiz access was tracked for participants. Learning, as defined by pre/post-test change score, was greatest in the presence of proctored assessment (online and text) (p = 0.027). In addition, use of practice quizzes had a stronger relative correlation with learning (r = 0.401; p<0.001) when compared to content page “hits” (r = 0.257; p = 0.024). Online course content paired with meaningful time-on-task (e.g. practice quizzes) was most effective when paired with proctored assessment.
Journal of Pharmaceutical Marketing & Management, Jan 1, 2003
The objective of this study was to develop an understanding of the impact of drug attributes on p... more The objective of this study was to develop an understanding of the impact of drug attributes on preference, for decision makers. Conjoint analysis of physicians, pharmacists, and consumers was conducted in an Ohio PPO. Subjects rated drug scenarios that varied on select attributes. Functional status was the noneconomic attribute with the greatest impact on preference. Frequency of administration and side effects were the factors that had the least impact. Physicians, pharmacists, and consumers did not tend to differ in the relative importance placed on noneconomic attributes. These three groups did differ in the manner in which they incorporated cost into the drug selection process.
This paper describes the development and use of web-based, prescription simulations in the practi... more This paper describes the development and use of web-based, prescription simulations in the practice skills lab setting. As part of a curricular revision for the Doctor of Pharmacy program at our
institution, a single laboratory series (Integrated Lab) was eveloped, concurrent with the first three years of the four-year professional program. To facilitate active learning in the Integrated Lab, prescription simulations were developed for students using a program developed at Idaho State University College of Pharmacy. Webstudies® is a teaching and assessment tool that presents problem-based learning scenarios for students to explore online. Students are able to probe each case and receive simulated patient, doctor and nurse responses. Retail and hospital pharmacybased, interactive prescription simulations were developed on the Webstudies" platform and used for group exercises in the lab. Student feedback has been very positive regarding the use of the simulations.
Clinical Therapeutics, Jan 1, 1997
A pharmacoeconomic evaluation was performed to determine the cost-effectiveness of perflenapent e... more A pharmacoeconomic evaluation was performed to determine the cost-effectiveness of perflenapent emulsion, a new contrast agent for use in echocardiography. A decision tree analysis was performed on data from the charts of 108 patients who had undergone stress echocardiography without contrast enhancement as part of a cardiac function or wall-motion study. An analysis of a theoretical cohort of patients was conducted to determine shifts in cost associated with perflenapent emulsion. Outcome was determined by the point at which the clinician was able to determine a treatment course for the patient based on the diagnostic information given. Stress echocardiography without contrast was identified as the most cost-effective path in terms of a conclusive test. Perflenapent emulsion shows a positive cost impact in patients who have had an inconclusive stress echocardiogram without the use of a contrast agent. These results are supported by a sensitivity analysis across a wide range of pricing for perflenapent emulsion, a wide range of cost for a stress echocardiogram, and up to 99% efficacy of contrast-enhanced stress echocardiography.
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 1, 2001
Abstract: A secondary data-reporting system used to scan the archives of a hospital’s automated s... more Abstract: A secondary data-reporting system used to scan the archives of a hospital’s automated storage and distribution cabinets (ASDCs) for indications of controlled-substance diversion is described. ASDCs, which allow access to multiple doses of the same medication at one time, use drug count verification to ensure complete audits and disposition tracking. Because an ASDC may interpret inappropriate removal of a medication as a normal transaction, users of ASDCs should have a comprehensive plan for detecting and investigating controlled-substance diversion. Monitoring for and detecting diversion can be difficult and time-consuming, given the limited report-generating features of many ASDCs. Managers at an 800-bed hospital used report-writing software to address these problems. This application interfaces with the hospital’s computer system and generates customized reports. The monthly activity recapitulation report lists each user of the ASDCs and gives a summary of all the controlled-substance transactions for those users for the time period specified. The monthly summary report provides the backbone of the surveillance system and identifies situations that require further audit and review. This report rovides
a summary of each user’s activity for a specific medication for the time period specified. The detailed summary report allows for efficient review of specific transactions before there is a decision to conduct a chart review. This report identifies all ASDC controlled-substance transactions associated with a user. A computerized report-generating system identifies instances of inappropriate removal of controlled substances from a hospital’s ASDCs.
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, Jan 1, 2001
Abstract: The impact of manufacturer back orders on the supply chain for pharmaceuticals in the i... more Abstract: The impact of manufacturer back orders on the supply chain for pharmaceuticals in the institutional setting was studied. A questionnaire was distributed during May and June 2000 to 600 institutional pharmacies affiliated with a major national drug and supply group purchasing organization.The instrument included questions on basic institutional demographics, perceptions about the frequency of manufacturer back orders for pharmaceuticals, the quality of communication with manufacturers and wholesalers about back orders, the two most significant back orders that had occurred in the 12 months preceding the survey, and the reasons for and impact of back orders. A total of 170 usable surveys were returned (net response rate, 28.3%). Reported manufacturer back orders included an array of drug classes, including blood products, antimicrobials, antiarrhythmics, benzodiazepine antagonists, thrombolytics, corticosteroids, and ntihypertensives. Respondents perceived significant back orders as increasing in frequency. Communication by manufacturers and wholesalers about back orders was reported to be relatively poor. A raw-material shortage was the most common reason given by manufacturers for back orders (36.5%), followed by a regulatory issue (23.2%). In most cases (92%), medical staff members had to be contacted, indicating an interruption in the normal drug distribution process. In over a third of instances, respondents stated that the back order resulted in less optimal therapy.A survey found that manufacturer back orders for pharmaceuticals were increasing in frequency and that information flow within the supply chain was insufficient to meet the needs of end users.
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Papers by Gregory Wellman
OBJECTIVES:A pilot study to determine if choice-based conjoint (CBC) analysis with hierarchical Bayes (HB) estimation for individual level part-worths could provide a stable model for attribute preferences for prescription benefit insurance; to pilot test the addition of MTMSs to a prescription benefit management model; and to pilot and compare logit-based utility estimates to HB estimations in a conjoint market simulator.
METHODS:A mail-based survey was conducted using a random sample of 1500 residents of the United States. A CBC analysis instrument was developed to provide a single-stated choice from a selection of different prescription benefit plans. Choice tasks were varied based on the attributes: co-payment, pharmacy access, formulary, level of pharmacist interaction including MTMSs and monthly premium. Analysis included logit-based and HB estimation for utilities, and preference share market simulation testing.
RESULTS:The utility estimations from HB analysis were consistent with those seen in the logit-based analysis. A goodness of fit of 83% (root likelihood) was achieved in the HB utility estimations with only 4 choice tasks per respondents and the inclusion of MTM-like services. There was convergence on preference shares from the market simulation between the 2 estimation methods.
CONCLUSIONS:The use of CBC analysis with HB estimation provided utilities similar to those estimated using aggregated logit-based methods, with the added benefit of respondent specific part-worth scores for each attribute level. A larger sample, changes in the instrument design, more panels (tasks) per respondent, and selection of conjoint methods may allow for more predictive information from market simulators.
control group design was employed. College students in a pharmacy curriculum, were randomized to two groups utilizing asynchronous, on-line content with a medical terminology module. Group A utilized proctored, on-line testing, while Group B utilized un-proctored on-line testing. Both were given a pre-test and post-test on medical terminology at the beginning and end of a sixteen week semester. The Learning and Study Strategies Inventory was administered to all students. On-line module delivery paired with proctored testing was more effective in promoting learning when compared to online module delivery paired with un-proctored testing. The constructs: anxiety, selftesting, attitude/interest and motivation were significant in predicting learning for proctored students. No significant model emerged for un-proctored students.
institution, a single laboratory series (Integrated Lab) was eveloped, concurrent with the first three years of the four-year professional program. To facilitate active learning in the Integrated Lab, prescription simulations were developed for students using a program developed at Idaho State University College of Pharmacy. Webstudies® is a teaching and assessment tool that presents problem-based learning scenarios for students to explore online. Students are able to probe each case and receive simulated patient, doctor and nurse responses. Retail and hospital pharmacybased, interactive prescription simulations were developed on the Webstudies" platform and used for group exercises in the lab. Student feedback has been very positive regarding the use of the simulations.
a summary of each user’s activity for a specific medication for the time period specified. The detailed summary report allows for efficient review of specific transactions before there is a decision to conduct a chart review. This report identifies all ASDC controlled-substance transactions associated with a user. A computerized report-generating system identifies instances of inappropriate removal of controlled substances from a hospital’s ASDCs.
OBJECTIVES:A pilot study to determine if choice-based conjoint (CBC) analysis with hierarchical Bayes (HB) estimation for individual level part-worths could provide a stable model for attribute preferences for prescription benefit insurance; to pilot test the addition of MTMSs to a prescription benefit management model; and to pilot and compare logit-based utility estimates to HB estimations in a conjoint market simulator.
METHODS:A mail-based survey was conducted using a random sample of 1500 residents of the United States. A CBC analysis instrument was developed to provide a single-stated choice from a selection of different prescription benefit plans. Choice tasks were varied based on the attributes: co-payment, pharmacy access, formulary, level of pharmacist interaction including MTMSs and monthly premium. Analysis included logit-based and HB estimation for utilities, and preference share market simulation testing.
RESULTS:The utility estimations from HB analysis were consistent with those seen in the logit-based analysis. A goodness of fit of 83% (root likelihood) was achieved in the HB utility estimations with only 4 choice tasks per respondents and the inclusion of MTM-like services. There was convergence on preference shares from the market simulation between the 2 estimation methods.
CONCLUSIONS:The use of CBC analysis with HB estimation provided utilities similar to those estimated using aggregated logit-based methods, with the added benefit of respondent specific part-worth scores for each attribute level. A larger sample, changes in the instrument design, more panels (tasks) per respondent, and selection of conjoint methods may allow for more predictive information from market simulators.
control group design was employed. College students in a pharmacy curriculum, were randomized to two groups utilizing asynchronous, on-line content with a medical terminology module. Group A utilized proctored, on-line testing, while Group B utilized un-proctored on-line testing. Both were given a pre-test and post-test on medical terminology at the beginning and end of a sixteen week semester. The Learning and Study Strategies Inventory was administered to all students. On-line module delivery paired with proctored testing was more effective in promoting learning when compared to online module delivery paired with un-proctored testing. The constructs: anxiety, selftesting, attitude/interest and motivation were significant in predicting learning for proctored students. No significant model emerged for un-proctored students.
institution, a single laboratory series (Integrated Lab) was eveloped, concurrent with the first three years of the four-year professional program. To facilitate active learning in the Integrated Lab, prescription simulations were developed for students using a program developed at Idaho State University College of Pharmacy. Webstudies® is a teaching and assessment tool that presents problem-based learning scenarios for students to explore online. Students are able to probe each case and receive simulated patient, doctor and nurse responses. Retail and hospital pharmacybased, interactive prescription simulations were developed on the Webstudies" platform and used for group exercises in the lab. Student feedback has been very positive regarding the use of the simulations.
a summary of each user’s activity for a specific medication for the time period specified. The detailed summary report allows for efficient review of specific transactions before there is a decision to conduct a chart review. This report identifies all ASDC controlled-substance transactions associated with a user. A computerized report-generating system identifies instances of inappropriate removal of controlled substances from a hospital’s ASDCs.