Master project

Prof. Eelko Hak's group is involved in real-world data-analysis of drug effects and safety as well as in trends in drug use. His interest is in applying novel designs and analytical strategies to deal with confounding by indication. Topics include drugs in diabetes, pregnancy, ashtma/COPD, infections, cardiovascular and neurological diseases. Most studies are done with the in-house IADB.nl prescription database sometimes in combination with the Lifelines database (PharmLines). Questionnaire studies, focus group interviews or audits are infrequently applied.

More information about Katja Taxis.

Topics for research projects at the Pharmaco-Economics Group

The Pharmaco-economics group at PTEE is lead by Professor Dr Feenstra. Talitha Feenstra does research on economic evaluations of personalized care by precision medicine.

In ongoing projects, she supports adaptive and targeted prevention and treatment using patient level modelling in diabetes mellitus and mental health care. Observational data, mostly based on routine data from daily clinical practice are available for analysis as part of these projects.

Furthermore, she cooperates regularly with pharmacists of the “Twentse Apothekers Organisatie” (TAO) regarding economic aspects of new pharmacy initiatives, for instance improved opioid use, while she also worked with community pharmacies in Friesland.  

For more information you can visit her MEPA page.

Master thesis projects are available in two research lines and on additional topics related to the research listed above:

1. Diabetes related work
2. Mental illnesses related work
3. Projects regarding economic aspects of community pharmacy projects (specifically on opioid use and heartfailure treatment)

Diabetes related work

The economic impact of novel oral antidiabetic medication

Suitable for a student in MPS or Pharmacy with an interest in health economics as well as data-analysis. Preferably willing to learn to work with R. Required courses: PharmacoEpidemiology.

In this project the aim is to investigate further the consequences of the change in the NHG-guidance regarding oral antidiabetic treatment. Using observational data on prescriptions from either pharmacy or GP registries, you work on time-series analyses and estimate medication costs.

For further information, please contact Dr TL Feenstra (t.l.feenstra rug.nl; 050 3632697 Tuesday-Friday).

“Quantifying the HBA1c history of diabetes patients in the Netherlands in relation to medication use”

Suitable for a student in MPS or Pharmacy with an interest in health economics as well as data-analysis. Preferably willing to learn to work with R. Required courses: PharmacoEpidemiology.

Health economic decision models are computer simulation models used for economic evaluations of new medical treatments. In diabetes medicine these are frequently applied since the chronic character of the condition implies that treatment benefits and costs will extend over long periods of time. Short term trial effects are then extrapolated with the help of the simulation model to support policy decisions concerning reimbursement of new drugs and implementation of public policy, for instance aiming at a healthy lifestyle.

The Dutch simulation model of diabetes, MICADO, has been developed using data from 2007 and is due to an update, using recent observational data. Data from two Dutch patient registries are available for further analysis. Aim is to get insight into trajectories of HbA1c.  Next to description, the link to covariates, especially medication use, next to age and gender, is to be investigated. In the end, the analyses will lead to new estimates of parameters for the health economic decision model.

The study will be part of joint work with RIVM, and VUmc.

Modeling Type 1 Diabetes

Suitable for a student in MPS or Pharmacy with an interest in health economics and simulation modeling. Requirements: not afraid of computer programming code (you will probably use R). Required courses: PharmacoEconomics

This project involves using an existing health economic model of Type 2 diabetes and adjust this for use in Type 1, or adjust an international model to the Dutch situation.

Aim of this project is to contribute to the development of a Dutch T1 Diabetes Model. More concrete, the student will perform a literature review concerning existing Type 1 models. Together with the supervisor and other researchers, it will then be determined whether a novel model will based on an existing interventional model, or the existing Dutch T2 model. The student will then work on adjusting code and model parameters, so the model becomes useful for the Dutch T1DM population.

For further information, please contact Dr TL Feenstra (t.l.feenstra rug.nl; 050 3632697 Tuesday-Friday).

Mental illnesses related work

Costing studies in mental health

1. Evaluate use and costs of psychofarmaca in individuals with depression and being treated in specialized mental health care
2. Evaluate use and costs of psychofarmaca in individuals with Schizophrenia and being treated in specialized mental health care

Suitable for a student in MPS or Pharmacy with an interest in health economics. Requirements: interested in working with real world data. Able to use SPSS or another statistical software package. Required courses: PharmacoEpidemiology

For both projects you will work along with researchers in Groningen, at the psychiatry department and in our own group. You will use data from a pharmacy registry. You will produce estimates of the costs of medication use related to different mental disorders and investigate differences among patients.  

For specific projects, specific research questions will be determined in discussion with the project leaders and depending on own interests.

Towards a model of Major Depressive Disorder

Suitable for a student in MPS or Pharmacy with an interest in health economics and simulation modeling. Requirements: not afraid of computer programming code (you will probably use R). Required courses: PharmacoEconomics.

You will work with a PhD student and analyze observational data from specialized mental healthcare to work towards a health economic decision model of Major Depressive Disorder.

More concrete, you will start with a review of existing models and extract crucial parameters and their sources. Then we will decide which parameters you will focus on. For these, you will perform data-analyses to end up with novel parameter estimates.

For further information, please contact Dr TL Feenstra (t.l.feenstra rug.nl; 050 3632697 Tuesday-Friday).

Other topics

Joint work with TAO

Depends on their requirements. Example projects:

• Cost-effectiveness of pharmacist-supported PPI deprescribing
• Cost-effectiveness aspects of avoiding medication overuse headache in migraine
• Investigating effects of a regional opiod-use protocol for non-oncological care. For this project a follow-up student is probably needed

Joint work with a consortium of researchers in pharmacy on the topic of heartfailure treatment

You will work in a recently funded project on the early HTA of heartfailure treatment.

Suitable for a student in MPS or Pharmacy  with an interest in health economics and simulation modeling. Requirements: not afraid of computer programming code (you will probably use R). Required courses: PharmacoEconomics.

If you are less of programmer, you could also support this project by investigating the current treatment for heartfailure and its associated costs.

“Evaluatie gepast voorschrijven van opioïden in Twente”

Dit project betreft een samenwerking met de Twentse Apothekers Organisatie (TAO-UA) en is daarom in het Nederlands omschreven.

De uiteindelijke masterscriptie kan in het Nederlands of Engels (voorkeur) worden ingeleverd. Voor de communicatie met TAO-UA is Nederlands praktisch.

Doel Kwantitatieve en kwalitatieve evaluatie van de effecten op opioïden-gebruik in de regio Twente van gezamenlijk beleid door TAO-UA voor meer gepast gebruik.

In de regio Twente werken de bij TAO-UA aangesloten apotheken samen met andere zorgverleners sinds januari 2024 volgens een regionaal protocol voor het voorschrijven en monitoren van opioïden bij niet-oncologische zorg. Het gaat dan bijvoorbeeld om het gebruik van oxycodon of morfine na operaties.

Afgelopen voorjaar heeft een masterstudent farmacie een zogeheten nulmeting verricht, dat wil zeggen zij heeft gekeken wat de huidige trends in voorschrijfgedrag zijn bij deze middelen. Ook is er een enquete uitgevoerd bij apothekersasssistenten.

Voor dit nieuwe project kun je data tot en met eind van 2024 gebruiken om te kijken of er sinds de nulmeting veranderingen hebben plaatsgevonden. Ook is het de bedoeling om de enquête te herhalen. Ook kun je na denken over andere aspecten van gepast opioïden gebruik en bijvoorbeeld verder in de hieraan verbonden kosten duiken, waarbij dan vooral bijwerkingen zoals vallen relevant zijn.

Begeleiding: Dr T.L. Feenstra, dr S. Balafas (GRIP, PTEE) en dr K. Ter Huurne (TAO-UA). Gedurende het project is er regelmatig overleg met de TAO-UA-apothekers. Dit kan betekenen dat je een paar keer naar Hengelo reist.

Vereiste vaardigheden: Ervaring met data-analyse, dan wel bereid om hier stevig in te investeren. De analyses worden namelijk in R gedaan. Communicatief sterk.

“Comparing the budgetary impact of different pricing mechanisms”

Objective: This project aims to assess the impact of different pricing mechanisms on the budget flows for different stakeholders in medicine reimbursement, specifically focusing on reimbursement of Cell and Gene Therapies (CGT).

Context: CGTs represent groundbreaking progress in treating severe and costly diseases, many of which currently lack adequate treatment options. While these therapies hold potential, they are also very expensive and not always cost-effective. Innovative pricing mechanisms, such as outcome-based or annuity-based payments, are explored as a way to address these problems. These mechanisms result in different sharing of risks and costs between the various stakeholders involved: Producers, patients, and payers (health insurance or national health system and in the end, all taxpayers) This project focuses on understanding how these mechanisms influence economic evaluations and what are the resulting budgetary impacts for different stakeholders.

The idea is to do so by integrating different pricing mechanisms into an existing cost-effectiveness (CE) model for the evaluation of eladocagene exuparvovec, a gene therapy for Aromatic L-amino acid decarboxylase (AADC) deficiency, which is a very rare inheritable disease that is among others characterized by feeding problems, movement disorders and increased risk of infections. This case study will then be used to draw conclusions regarding the different pricing mechanisms and how they impact on the costs and benefits for the different stakeholders involved. The model is programmed in R.

The project will take place at Asc Academics. Asc Academics is a health economics and market access consultancy that works with pharmaceutical and healthcare organizations and has a team of over 35+ employees based in Groningen and Utrecht.

Project Tasks:

1. Short Literature review on the effect of pricing mechanisms on cost-effectiveness and budget impact.

2. Model Application:

• Familiarize yourself with the existing cost-effectiveness model used in evaluating CGT.
• Modify the model to incorporate various pricing mechanisms, such as:

- Outcome-based pricing
- Annuity-based pricing
- Traditional one-time payments

• Analyze how these mechanisms affect the model’s results, particularly regarding cost-effectiveness and budget impacts for different stakeholders.
  

3. Clinical Data Research Extrapolation in R:

• Use R to perform data extrapolation of clinical outcomes.
  

4. Budget impact:

• Identify how integrating innovative pricing mechanisms affects what each stakeholder receives in terms of money and health benefits

• Address how uncertainty on future outcomes affects this

• Discuss how this may affect reimbursement decisions concerning CGT.
  

You report on your findings in a master thesis.

Supervision from RUG: Dr T.L. Feenstra. Supervision from Asc Academics: Rimma Velikanova, one of the employees in the Groningen office. More information please contact: t.l.feenstra rug.nl

As a senior lecturer, Dr Nynke Schuiling-Veninga is involved in education and research within the fields of pharmacoepidemiology, pharmacotherapy and pharmacy practice research. She supervises bachelor- and master research projects done with the in-house IADB.nl prescription database focusing on the effects and safety of drugs use and trends in the utilization of drugs. Especially the use and safety of drugs during pregnancy and use and safety of psychotropic drugs have her interest. Besides this, many other topics have her interest too like the treatment of neurological disorders (migraine, epilepsy), prescribing of antibiotics and utilization of drugs among children and adolescents.

Liset van Dijk is professor of Pharmacy Health services research. Her work concentrates on pharmacy practice and policy research. Main research areas include: adherence tot medication, patient-pharmacist communication, the patient perspective on medication use, organisation of primary care, implementation research and e-health solutions to support medication use. In Liset's research line a wide variety of research methods are applied: quantitative (survey, database analyses) and qualitative (interviews, focus groups, video observations) and mixed-method. Liset works together with different organisations and connects students with these organisations. In 2022-2024 students worked for example together with Nivel, Sint Maartenskliniek, SIR institute for Pharmacy practice and policy, UMCG, and Stichting Health Base. Liset is the coordinator of the Make It consortium that studies implementation of drug utilization interventions. For this project, several master projects will become available the upcoming years.

Frank Klont is an assistant professor in Personalized Pharmacotherapy working both in the department of PharmacoTherapy, -Epidemiology and –Economics and in the UMCG’s department of Clinical Pharmacy and Pharmacology. His position is aimed at the integration of knowledge on the drug profile with a patient’s clinical profile, co-medication, genetic makeup, and biomarker status with the goal to contribute to further personalization of drug treatments. Having a background in pharmacy, clinical chemistry, bioanalysis, omics research, and clinical data analysis, he supervises data-driven projects, for example on antihypertensive, antidiabetic, immunosuppressive, and over-the-counter drug use in various clinical settings. In addition, he supervises laboratory-based projects, for example aimed at developing therapeutic drug profiling workflows to study medication adherence or to study the metabolic fate of drugs in a real-world setting.

Topics for Research in Clinical Pharmacy, in particular Oncology Pharmacy

The research of Prof Frank Jansman focuses on clinical pharmacy projects with a specific interest in oncology. Reseach lines include medication surveillance and pharmaceutical care for cancer patients and factors influencing anti-cancer drug exposure in patients. Given his chair of the Dutch Expertgroup Anticancer Drug Interactions, research to co-medication, alternative medicines, and food in combination with anti-cancer drugs is a major topic.

Next to these research lines, pharmaco-economics of expensive drugs, assessment and accessibility of new drugs, comparative outcomes of anticancer drugs in clinical trial phases versus real-world use, analysis of clinical trial phases in cancer drug development, and pharmacovigilance of anti-coagulant treatment are currently explored.

The main research target populations regard to oncology, hematology, palliative care, geriatry (complex pharmacotherapy) and anti-coagulant therapy.

Setting

The hospital setting, i.e. Deventer Hospital in cooperation with UMCG and other hospitals in the Northern part of the Netherland, gives an excellent opportunity to perform research in a clinical environment.

Students will closely work together with medical specialists, hospital and policlinic pharmacists, AIOs, ANIOs, master- and PhD-students. Dependent on the research topic, students will experience or will be involved the activities in a hospital and policlinic pharmacy. This may help to decide if a career as a hospital or policinic pharmacist, whether or not in combination with research, is eligible.

Contact

When you are interested or have any questions, you are welcome to meet in person in Groningen at the department of PharmacoTherapy, -Epidemiology and –Economics (PTEE), in the Deventer Hospital, or on-line. Please E-mail f.jansman dz.nl and f.g.a.jansman rug.nl for contacting.

Prof. van Roon offers possibilities tot conduct your master research project in het hospital setting. In cooperation with PhD students ((hospital) pharmacists, medical specialists) you work on projects that have a very close relation to daily clinical practice in the intramural setting. The research questions are characterized by a high level of direct clinical relevance. The fields of research are very diverse, for example within the field of haemato-oncology, anticoagulation, bariatric pharmacology and hospital psychiatry. Locations are large teaching or peripheral hospitals in the Northern part of The Netherlands. Besides the focus on your research project all hospitals offer the possibility to dive deeper into the intramural care setting. This facilitates the development of your idea whether to pursue a career as hospital pharmacist.