October 2021 Diplomat Spotlight: Rowe B. Brookfield, PharmD, CPE

Diplomat at Union University

How did you become involved in AMCP?   
As a resident in 1995. I was searching for the most fitting publications to report work I was doing in both member satisfaction with pediatric nocturnal enuresis and the integration of case management and pharmacy in managed care environments. In my search, I came upon a relatively new and small organization called AMCP. I discussed it with my very forward-thinking residency director and some other career-guiding people in my life. I was encouraged to join. I did and was a member for several years.   
My career and life path later diverged from a managed care focus, taking me back into a clinical role and then into medical affairs role within the pharmaceutical industry. In the early 2000’s, managed care was just becoming noticed within industry. My previous training and experience with managed care led to me being utilized in multiple projects and initiatives involving the flow of the healthcare dollar. This resulted in ever-increasing and evolving health outcomes and managed care-focused medical affairs roles. As a result, for at least the last 10+ years, I have been increasingly involved with AMCP.  
  
What interested you the most about managed care and ultimately led you to pursue a career in managed care pharmacy? 
Upon graduation from the University of Tennessee, I was contemplating my career path. I was really torn between pursing a pediatric clinical residency and going to medical school. In good fortune, I was made aware of a new type of residency surrounding ‘managed care and pharmacoeconomics.’ This really intrigued me as an option I had not yet considered. Ultimately, I chose this non-traditional pharmacy path because it involved various aspects of clinical pharmacy, patient-centered activities, and efficient use of resources; this seemed to present the potential for me to make positive impact on a larger scale than either of my previously considered options.  
  
What was your first job or position in managed care?   
As eluded to in my previous responses, my first managed care job was as a managed care and pharmacoeconomics resident. The residency was with a small, innovative private consulting company. The company had various clients that spanned from large medical systems to pharmaceutical industry. Within the company, I was afforded many opportunities that neither I, nor my pharmacy school classmates and faculty, could fully believe. It exposed me to the then infantile science of pharmacoeconomics and the growing field of managed health care. (At that time, managed care was most entrenched on the west coast and vehemently fought by healthcare professionals elsewhere.) The residency aligned me a staff-model HMO on the west coast to give me insight into the internal workings and business model of the HMO, allowing me to observe the ‘gears’ that kept the HMO running. 
 
The residency led to a position within the consulting company and my responsibilities increased with expansion into phase III & IV research that incorporated health outcomes to help industry further justify their place in the market. Some of these activities included the creation of ‘formulary kits,’ the precursor of today’s AMCP Dossier, assisting with some clients’ formulary management, and holding leading advisory boards. 
 
My roles over the last 10+ years in industry have generally involved being managed care and health outcomes leads at various companies. I have often been charged to help partner industry with managed care organizations to ensure the most appropriate and efficient utilization of marketed products.  
  
What does a typical day or week look like in your current role?   
With the volatile environment of healthcare, especially the pharmaceutical industry, today, there is no such thing as a ‘typical’ day or week; there may not even be a typical month, quarter, or year. However, my current role involves and divides my time between three branches: 1. HEOR lead: I am responsible for developing the HEOR strategic research plans for both our marketed and pipeline products, and then managing the projects; 2. Managed Care lead: I am in charge of developing product presentations that are to be delivered to MCOs upon request; and, 3. I have some field responsibilities to meet with key medical experts to discuss research activities and respond to medical information requests.  
  
What type of interactions have you had with your AMCP student chapter or school of pharmacy?   
I am the diplomat for a fairly young pharmacy school at Union University in west Tennessee. With it being relatively new, interactions have been rather limited. I have liaised with some faculty members and given AMCP student chapter information presentations; but to date, there has not been enough interest (committed students or faculty) to form a new chapter.  
  
Words of advice?  
Stay engaged…in all aspects of our profession. We are in a time where knowledge is increasing at a faster rate than ever before in human history. We are also facing increased scrutiny with the way healthcare services are delivered, recorded, and allocated. This leads to a rapidly-changing, unpredictable environment where what we know today, may be totally different (and outdated) for what we need to know for tomorrow. To quote the FAA Flight Instructor manual (no, I am not a pilot, but read it in preparing for my CPE certification): No individual’s understanding of anything is ever “complete.”…Learning occurs continuously throughout a person’s lifetime. 
 
We must remember this and constantly strive to as stay as informed as possible. We may not always be able to be the first to adopt new ideas, but we certainly cannot afford to be the last...lest we become archived in the history of our profession.