Niteesh Choudhry

Niteesh K. Choudhry, MD, PhD, is a Professor of Medicine at Harvard Medical School and an Associate Physician in the Division of Pharmacoepidemiology and Pharmacoeconomics and the Hospitalist Program at Brigham and Women’s Hospital. His research focuses on the impact of medication costs and drug benefit design on the use of and adherence to medications for common chronic conditions, such as coronary artery disease, hyperlipidemia and diabetes.

He is the principal investigator of the Post-MI Free Rx and Event and Economic Evaluation (MI FREEE) trial, which is a randomized policy trial based on economic models he and his colleagues constructed to evaluate the clinical and economic benefits of reducing patient cost-sharing for medications of proven efficacy. This nationwide trial enrolled more than 5,800 patients who were recently discharged from hospital after myocardial infarction and randomized them to receive full drug coverage or their usual levels of drug insurance for secondary prevention medications. Related to this, he has conducted policy evaluations of cost-sharing reductions recently introduced by large insurers and employers. His work is funded by the Robert Wood Johnson Foundation, the Commonwealth Fund, the Aetna Foundation, CVS Caremark, the Agency for Healthcare Quality and Research and others.

Dr. Choudhry attended McGill University and then received his MD and did his residency training in Internal Medicine at the University of Toronto. He served as Chief Medical Resident for the Toronto General and Toronto Western Hospitals and was also Director of the Medical Clerkship Program at the Toronto General Hospital. He did his PhD in Health Policy at Harvard University, with a concentration in statistics and the evaluative sciences, where he was a Frank Knox Memorial and Canadian Institutes of Health Research Post-Doctoral Fellow. He was also a Fellow in Pharmaceutical Policy Research at Harvard Medical School. He practices inpatient general internal/hospital medicine at Brigham and Women’s Hospital and is actively involved in resident education.

Selected Publications | Current PubMed Search Results

Medication Costs and Adherence

• Choudhry NK, Avorn J, Antman EA, Schneeweiss S, Shrank WH. Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysis. Health Affairs 2007; 26: 186-194.
• Choudhry NK, Patrick AR, Antman EA, Avorn J, Shrank WH. The cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation 2008; 117 1261-1268.
• Choudhry NK, Brennan T, Toscano M, Spettell C, Glynn RJ, Rubino M, Schneeweiss S, Brookhart MA, Fernandes J, Mathew S, Christiansen B, Antman EM, Avorn A, Shrank WH. Rationale and Design of The Post-Myocardial Infarction Free Rx Event and Economic Evaluation (POST-MI FREEE) Trial: a randomized evaluation of first-dollar drug coverage for post-MI secondary preventive therapies. American Heart Journal 2008; 156: 31-36.
• Choudhry NK, Setoguchi S, Levin R, Winkelmayer WC, Shrank WH. Trends in adherence to secondary prevention medications in elderly post-myocardial infarction patients. Pharmacoepidemiology and Drug Safety 2008; 17: 1189-1196.
• Choudhry NK, Shrank WH, Levin R, Lee LJ, Jan S, Brookhart MA, Solomon DH. Measuring concurrent adherence to multiple related medications. American Journal of Managed Care; 2009;15:457-64.
• Choudhry NK, Fischer MA, Avorn J, Liberman, LN, Schneeweiss S, Pakes, J, Brennan TA, Shrank WH. The implications of therapeutic complexity on adherence to cardiovascular medications. Archives of Internal Medicine2011; 171: 814-822.
• Choudhry NK, Saya UY, Shrank WH, Greenberg JO, Melia C, Bilodeau A, Kadehjian EK, Dolan ML, Dudley JC, Kachalia A. Cost-related medication underuse: prevalence among hospitalized managed care patients. Journal of Hospital Medicine; doi: 10.1002/jhm.948. [Epub ahead of print]
• Choudhry NK, Avorn J, Glynn RJ, Antman EM, Schneeweiss S, Toscano M, Reisman L, Fernandes J, Spettell C, Lee JL, Levin R, Brennan T, Shrank WH. Full coverage for preventive medications after myocardial infarction. New England Journal of Medicine; in press

Prescription drug policy

• Choudhry NK, Detsky AS. A perspective on U.S. drug re-importation. Journal of the American Medical Association (JAMA)2005; 293: 358-61.
• Kesselheim AS, Choudhry NK. The international pharmaceutical market as a source of low-cost prescription drugs for U.S. patients. Annals of Internal Medicine 2008; 148: 614-619.
• Fischer MA, Choudhry NK, Winkelmayer WC. Impact of Medicaid prior authorization on angiotensin receptor blockers: can policy promote rational prescribing? Health Affairs 2007; 26: 800-807.
• Choudhry NK, Lee JL, Agnew-Blais J, Corcoran CP, Shrank WH. Drug company-sponsored patient assistance programs: a viable safety net? Health Affairs 2009; 28: 827-834.
• Choudhry NK, Shrank WH. Four-dollar generics – increased accessibility, impaired quality assurance. New England Journal of Medicine 2010; 363: 1885-1887
• Shrank WH, Choudhry NK. Time to fill the doughnuts: health care reform and Medicare Part D. New England Journal of Medicine 2011; 364: 598-601.
• Gagne JJ, Choudhry NK. How many me-too’s is too many? Journal of the American Medical Association 2011; 305: 711-712

Clinical and economic consequences of evidence-based medication use

• Choudhry NK, Anderson G, Laupacis A, Ross-Degnan D, Normand SL, Soumerai SB. The impact of adverse events on warfarin prescribing in atrial fibrillation: a matched-pair analysis. BMJ 2006; 332: 141-5.
• Choudhry NK, Levin R, Winkelmayer WC. Statins in elderly acute coronary syndrome patients: an analysis of dose and class effects in typical practice. Heart 2007; 93: 945-951.
• Choudhry NK, Levin R, Avorn J. The economic consequences of non-evidence-based clopidogrel use. American Heart Journal 2008; 155: 904-909.
• Kulik A, Brookhart MA, Levin R, Ruel M, Solomon DH, Choudhry NK. Impact of statin use on outcomes after coronary artery bypass graft surgery. Circulation 2008; 118: 1785-1792.
• Patrick AR, Avorn J, Choudhry NK. The cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation.Circulation: Cardiovascular Quality and Outcomes; 2009; 2: 429-36.
• Choudhry NK, Patrick AR, Glynn RJ, Avorn J. The cost-effectiveness of C-reactive protein testing and rosuvastatin treatment for patients with normal cholesterol levels. Journal of the American College of Cardiology; 2011; 57: 784-9.
• Desai NR, Shrank WH, Fischer MA, Avorn, J, Liberman JN, Schneeweiss S, Pakes J, Brennan TA, Choudhry NK. Patterns of medication initiation in newly diagnosed diabetes mellitus – quality and cost implications. American Journal of Medicine; in press.