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Q&A with Dr. Karen Mulligan: Incorporating Patient Preferences for Risk Into Value Assessment

January 22, 2024

Karen Mulligan, PhD, is a research assistant professor of health policy and management at the University of Southern California and a recipient of a 2023 Mid-Career Faculty Grant in Value Assessment-Health Outcomes Research from the PhRMA Foundation.

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Tell us a bit about yourself and how you became interested in research.

I am an assistant research professor in the Sol Price School of Public Policy and fellow with the Leonard D. Schaeffer Center for Health Policy & Economics at the University of Southern California. I was first exposed to research during my upper-level undergraduate economics coursework at the University of North Texas. I had already taken a liking to statistics, and the idea of trying to solve interesting problems with data appealed to me.

Briefly describe your PhRMA Foundation-funded research project and its potential impact on patients.

Cost-effectiveness analysis (CEA) is a method for assessing the costs and health outcomes associated with health care interventions. My project is an application of generalized cost-effectiveness analysis (GRACE), which is a relatively new approach to value assessment that incorporates preferences for risk into traditional CEA. Risk preferences are estimated by examining how individuals make treatment decisions, such as when deciding between an option with a certain health outcome versus an option with an uncertain outcome. Incorporating risk preferences has implications for equity and how we value treatments for illnesses with varying levels of disease severity. Using risk preference estimates from a previous paper that I co-authored, I will apply the GRACE model to diabetic macular edema (DME) — an eye condition that affects nearly 1.1 million people in the U.S. and is the most common cause of vision loss among adults with diabetes. The value of treatments for DME have been studied previously using traditional CEA, so this project will allow us to compare how GRACE changes value estimates and recommendations for decision-makers.

How will the PhRMA Foundation’s support impact your research and your career?

This grant will allow me to continue expanding my portfolio of GRACE-related research. I also view it as a first step in developing a larger portfolio of projects at the intersection of GRACE and ophthalmology.

What has been challenging in your research journey and how did you overcome it?

I like the challenge of learning new methods, so there have been times when I haven’t had a clear research focus because I’m working on projects across a range of topics. This isn’t necessarily an issue in and of itself, but certainly there are benefits to becoming more of an expert in one or two areas. I’ve tried to be more discerning about saying no to working on interesting projects that are too tangential to my core research areas.

What advice would you give to other young researchers, such as those applying for PhRMA Foundation awards?

The mentors I’ve had throughout my education and career have been invaluable. Find good mentors who can help give perspective. It’s also important to find coauthors who challenge you and push you to grow as a researcher.

What are your future career aspirations?

I enjoy doing research, so I will be happy as long as I can continue to work on interesting topics with good colleagues. Ideally though, I want my research to have real-world impact, whether that means influencing policy or advancing methods in health economics.

Learn more about the PhRMA Foundation’s fellowship and grant opportunities. Check out more researcher stories on our blog.