Rachel Breslau (RB): How did you get involved in health economics and outcomes research?
Peter Neumann (PN): In 1983 I graduated with a bachelor’s degree in economics from University of Pennsylvania. I went to Washington and began working as a research assistant on Capitol Hill, interested in public policy. Eventually, I started working on health policy issues. Even then there was demand for people who were doing research and policy analysis on health economic issues, and it seemed like an exciting area to be in. And I ended up going back to school for a doctoral degree at the School of Public Health at Harvard.
RB: What drew you to cost-effectiveness analysis specifically?
PN: If you're interested in economics and policy, you're interested in how society spends its resources, and how we can spend more efficiently to improve people's health. And one of the important tools we use to help us understand that is cost-effectiveness analysis. So it's a natural part of the landscape. And the program that I was in at the Harvard School of Public Health (HSPH), was run by my great mentor, Milton Weinstein, who was one of the founders of the field of cost-effectiveness in healthcare. I was extremely fortunate to be at the School and to be around Milt.
RB: Can you tell me the story of starting CEVR?
PN: Josh Cohen and I had met as doctoral students at Harvard in the early 1990s and were back at HSPH as junior faculty and researchers in the late 90s, though working in different areas. At some point, we began collaborating on projects. Then, in the mid-2000s we had an opportunity to come here to Tufts Medical Center to start a new research center in the Institute for Clinical Research and Health Policy Studies. It was a kind of startup. And that was exciting to us, the idea that we could start fresh and try to develop something. So we created the Center for the Evaluation of Value and Risk in Health (CEVR) in January 2006. As we say, we took the T (Green Line) from Longwood all the way down to Tufts Medical Center and started this program. At first, it was just Josh and me and a research assistant and programmer. Since then, we've been building the program, recruiting new faculty and researchers and post-doctoral fellows, trying to do important work and make an impact. And here we are.
RB: What does a day in your life as the Director of CEVR look like today?
PN: I try to write and do my own research in the early mornings. After that, the rest of the day takes over with meetings and emails and everything in-between.
RB: What are a few of your favorite things that you're working on right now?
PN: Well, I'm very interested in value measurement in health care and how we can align pricing of technologies and services with value. There are many important questions – for example, can we (should we) incorporate aspects of value such as spillover effects into other sectors, people’s preferences regarding risk and uncertainty and expectations, and future life cycle pricing dynamics into cost-effectiveness analysis? It's very important for thinking about how to value therapeutics and vaccines for COVID-19, but it comes up in all areas of health and medicine.
RB: What are you most proud of in your career?
PN: When I think about my career, I think about the people with whom I’ve had the opportunity to work with here at CEVR and elsewhere, and I take pride in their accomplishments and the work we’ve done together, including many research projects and the databases we’ve developed and maintained. I’m also proud of the work that my colleagues did on the Second Panel in Cost-Effectiveness in Health and Medicine that I had the opportunity to co-chair, and the recent book on value-based drug pricing that my co-authors, Josh Cohen and Dan Ollendorf, and I wrote. We've all tried to contribute in a positive way to improve health and health care and I hope we’re able to do that.
RB: What advice do you have for students or people who are new to health economics and outcomes research?
PN: I tell everyone to be persistent, don't get discouraged. And to have a thick skin if you're going to be a researcher. Your papers will get rejected, your grant proposals will get turned down, there will be setbacks. But there will also be rewards and achievement and those papers and proposals that do get accepted. So I would just encourage students to not be discouraged and to find issues about which you are passionate – and then to double down and be even more persistent and to focus on impactful work that can improve people’s health.
It's also important to have a high degree of integrity. And so I would encourage people to be honest. We all make mistakes. We should own them and work to improve. It's okay to fail. Be a good collaborator. Give people credit. I hope we've done that here.
RB: I'm wondering if there is any memory of your time at CEVR that stands out to you.
PN: We have an annual CEVR meeting every April where we showcase our research and databases. We work hard in the weeks leading up to it. A lot has to happen quickly. I have a lot of memories of sitting in this room [the CEVR conference room] with people going over talks and trying to polish their research presentations, and reviewing many other details. I have fond memories of those nights before the opening and the “cast party” after.
RB: When you were a kid, what did you want to be when you grew up?
PN: I would tell people that I wanted to be an astronaut. I think I did it because people seemed to like that answer. And I guess I liked the space program. When the astronauts landed on the moon, I was eight years old, and it was a big deal. In truth, though, I had no idea what I wanted to do when I grew up.
RB: And then finally, what do you do when you're not doing health economics and outcomes research?
PN: Well, I like to read and I try to read things outside of the field. I like to read mostly nonfiction (history, current events, books about science and innovation and technology, and biographies). I run – outside or on my treadmill. In my youth, I was a decent distance runner – now I just kind of trudge along. My wife and I like to watch movies and sometimes a series on Netflix or HBO. We’re now watching “Better Call Saul” and “Succession.”
Rachel Breslau is a research assistant at CEVR. She works with Peter on a variety of projects. Rachel graduated from Tufts University in 2021 with a BA in Economics and Political Science.