Stephen Soumerai, Sc.D.

May 16, 2013

Stephen Soumerai, Sc.D., is Professor of Population Medicine at Harvard Medical School and Harvard Pilgrim Health Care Institute, where he directs the Drug Policy Research Group, a research and fellowship training program focused on pharmaceutical outcomes and quality of health care.  He also co-chairs the Statistics and Evaluative Sciences Concentration within Harvard’s health policy Ph.D. program. 

Dr. Soumerai is known nationally and internationally for his work on the impacts of health policies and methods to improve the quality of medical practice.  His recent research has focused on cost-related underuse of medications, as well as the impacts of drug coverage and cost containment policies on access to effective medications, quality and costs of care, and clinical outcomes among vulnerable populations.  Dr. Soumerai has published more than 250 articles in leading scientific journals such as the New England Journal of Medicine and the Journal of the American Medical Association.  He frequently advises Congress, state legislatures, and federal and international agencies on the design of drug cost containment, coverage and quality of care policies, and evidence-based health policy.  Dr. Soumerai has published numerous op-eds in leading news outlets, including The Wall Street Journal, The Washington Post, Newsweek, The Huffington Post, and The Boston Globe on subjects including Medicare drug coverage, rushed implementation of health IT, undertreatment of pain, state censorship of health research, and arbitrary penalties for hospital readmissions.

Dr. Soumerai received his Doctor of Science in Health Services Administration from Harvard School of Public Health.

In a HCFO-funded study, Dr. Soumerai, Christine Lu, Ph.D., and colleagues examined the impact of Maine Medicaid’s prior authorization policy on patients who suffer from bipolar disorder.  Prior authorization (PA) is a cost-control measure that requires physicians to obtain pre-approval for a medication in order for a patient to receive insurance coverage for the drug.  While PA can be an effective approach for drugs that are readily substitutable, it may have unintended consequences for patients whose medications are less interchangeable, such as individuals with mental health disorders.

In their study, Dr. Soumerai and colleagues assessed medication discontinuation and frequency of health services use among Maine Medicaid patients newly-treated for bipolar disorder before and after the state’s PA policy went into effect.  They found higher rates of medication discontinuation in the policy cohort than in the pre-policy cohort, regardless of disease severity.  After discontinuing medications for treating bipolar disorder, patients with more severe bipolar disorder reduced their outpatient mental health visits, possibly reflecting lower compliance with all health care, whereas patients with a less severe condition increased emergency room visits, suggesting that the PA policy and its associated medication discontinuation may have exacerbated disease symptoms or steered patients to these care settings to manage medication access issues.  These findings suggest that the PA policy can be a serious barrier to medication availability and adherence, and may prompt potentially harmful changes in patients’ health seeking behavior.

Additional information about Dr. Soumerai’s HCFO-funded work is available here.