Jerry Avorn

Jerry Avorn
Jerryavorn.jpg

Jerome "Jerry" Lewis Avorn, M.D. is a Professor of Medicine at Harvard Medical School and Chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. He invented the practice of "academic detailing" in which pharmacists, nurses, and physicians educate doctors about cost-effective prescribing practices using the same tactics that drug companies employ to market their products. He received a B.A. from Columbia University in 1969 and M.D. from Harvard Medical School in 1974.

Contents

Biography

Dr. Avorn was born February 13, 1948 in New York City and grew up in Rockaway, Queens. While attending Columbia University during the tumultuous opposition to the Vietnam War and American civil rights movement, he distinguished himself as a leading campus activist against the Vietnam War with his investigative journalism for the Columbia Daily Spectator. In the summer of 1969, he wrote Up Against the Ivy Wall with fellow Spectator journalists about the campus uprisings at Columbia.

Dr. Avorn graduated from Harvard Medical School with an M.D. in 1974. He was a resident at the Cambridge Hospital in Cambridge, Massachusetts and then at the Beth Israel Hospital (now the Beth Israel Deaconess Medical Center in Boston, Massachusetts. He became an Associate Professor at Harvard Medical School in 1985 and a full Professor in 2005.

In 1983, he published his first paper on academic detailing. The practice has now been taken up by several hospitals and governments, such as Pennsylvania, Kentucky, Australia, Israel, and Nova Scotia. His work on academic detailing was featured in the Wall Street Journal and on The Daily Show.

His later research documented the high rate at which patients do not take their medications as directed, and the factors (older age, low income, non-white race) associated with this common problem. Other studies measured the risk of side effects caused by specific drugs, such as the appearance of a condition similar to Parkinson's disease in older patients taking certain potent tranquilizers. He and his colleagues have also published several studies on the cost-effectiveness of drugs, systematically comparing a product’s beneficial effects with its price tag.

In 1996 he published Reduction of bacteriuria and pyuria after ingestion of cranberry juice in the Journal of the American Medical Association which identified cranberry juice as an effective means of controlling urinary tract infections in elderly women.

The unit he now heads, the Division of Pharmacoepidemiology and Pharmacoeconomics (known internally as DOPE), continues to study the relationship between the benefits, risks, and costs of medications; it also conducts a teaching program on these topics at the Brigham and Women’s Hospital for the Harvard medical students, interns, and residents studying there. Dr. Avorn is the author of over 200 papers in the medical literature on medication use and outcomes, and is one of the most frequently cited researchers in the field of social science and medicine. A cogent advocate for more rational prescribing, he has testified several times before Congress on medication-related issues, and his work has been featured on National Public Radio (All Things Considered, Morning Edition, The Connection) and in The Washington Post, The Boston Globe, and USA Today. Dr. Avorn is also past president of the International Society of Pharmacoepidemiology [1].

His paper on coxibs was one of the first medical research papers to demonstrate that Vioxx increased some patients' risk of heart attack and stroke. In 2006 he testified as a plaintiff’s expert witness in the Vioxx litigation, but he donates all profit from his involvement to his Alosa charitable foundation.

Dr. Avorn lives in Brookline, Massachusetts with his wife, community activist Karen Tucker. They have two grown sons: Andrew Avorn (Columbia University Class of 2008), and Nathaniel Avorn (Connecticut College Class of 2003). In his leisure time, Dr. Avorn enjoys napping, reading, and travel.

Academic Detailing

Early in his medical career, Dr. Avorn established an interdisciplinary research team to study how physicians prescribe drugs, how patients take them, and the clinical and resulting economic outcomes. His studies helped define how pharmaceutical company promotion and scientific information interact to shape doctors’ decisions about which drugs to use, with the former often dominating.

In the 1980s, Dr. Avorn devised a new approach to improve doctors’ ability to make accurate prescribing decisions. He observed that the promotional activities of pharmaceutical companies and their sales representatives (known as “detail men”) used cutting edge strategies to change physician behavior and sell their products. By contrast, medical school faculty may have had a more complete and balanced grasp of the scientific issues, but were much less effective communicators. He devised an approach known as “academic detailing” which took the effective communications strategies of the drug industry and used them to present unbiased, evidence-based education about proper prescribing. In several papers in the New England Journal of Medicine, JAMA, and other medical journals, he and his colleagues showed that such programs could improve prescribing decisions and more than cover their costs through reductions in improper medication expenditures. Today, programs based on this work are in place in the United States, Canada, Europe, Australia, and throughout the developing world.

Powerful Medicines

Dr. Avorn is the author of the 2004 book "Powerful Medicines" About the book, Senator Edward M. Kennedy (D-MA) said, “Powerful Medicines” is a must read for anyone interested in the use, abuse, and economics of prescription drugs. The issues it addresses are central to the ongoing debate about how to reduce the cost and improve the quality of health care in America."

Education

Date Degree Institution Subject
1988 Certification American Board of Internal Medicine Geriatric Medicine
1977 Diplomate American Board of Internal Medicine
1975-1977 Resident in Internal Medicine Beth Israel Hospital, Boston, MA
1974-1977 Clinical Fellow in Medicine Harvard Medical School, Boston, MA
1974-1975 Intern in Medicine Cambridge Hospital, Cambridge, MA
1974 M.D. Harvard Medical School, Boston, MA
1974 Certification National Board of Medical Examiners
1974 License State of Massachusetts
1969 A.B. Columbia University, New York, NY

Appointments and Affiliations

Dates Title Organization City, State/Province Country
1998- Chief, Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital Boston, MA United States
1992–Present Physician Brigham and Women's Hospital Boston, MA United States
1992–Present Attending Physician Brigham and Women's Hospital Boston, MA United States
1990–Present Associate Professor of Medicine Harvard Medical School Boston, MA United States
1989-1994 Physician Beth Israel Hospital, Department of Medicine Boston, MA United States
1987-1989 Associate Physician Beth Israel Hospital, Department of Medicine Boston, MA United States
1986-1992 Associate Physician Brigham and Women's Hospital Boston, MA United States
1985-1990 Associate Professor of Social Medicine Harvard Medical School Boston, MA United States
1984-1987 Assistant Physician Beth Israel Hospital, Department of Medicine Boston, MA United States
1981-1992 Attending Physician Beth Israel Hospital Boston, MA United States
1979-1985 Assistant Professor of Social Medicine and Health Policy Harvard Medical School Boston, MA United States
1977-1984 Assistant in Medicine Beth Israel Hospital, Department of Medicine Boston, MA United States
1977-1981 Attending Physician Beth Israel Hospital Boston, MA United States
1977-1979 Instructor in Preventive and Social Medicine Harvard Medical School Boston, MA United States


Honors/Awards    

Notable Research Papers

-A new approach to reducing suboptimal drug use

- Cardiovascular outcomes in new users of coxibs and nonsteroidal antiinflammatory drugs: High-risk subgroups and time course of risk

- Reduction of bacteriuria and pyuria after ingestion of cranberry juice

-Nonsteroidal anti-inflammatory drug use and acute myocardial infarction.

External links

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