Catching Up with Pilot Grant Recipients Ali Jalali, Austin Kilaru, and Hao Zhang

Every spring, the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH) awards competitive pilot grants to investigators interested in developing health economic research in our areas of interest, with a focus on junior investigators and trainees. Funded by the National Institute on Drug Abuse, CHERISH pilot grants provide these investigators an opportunity to initiate new research and address the feasibility of their proposed study before applying for additional funding.

While 2020 ushered in challenging moments, the sixth cohort of pilot grant recipients, Ali Jalali, Austin Kilaru, and Hao Zhang, concluded their funding year with new analytical skills and unique accomplishments. “We have been fortunate with all of our pilot grant recipients. They do great and interesting work, and this class was no different,” says Pilot Grant & Training Core Director Brandon Aden.

As CHERISH welcomes a new group of pilot grant recipients, we are delighted to continue supporting the sixth cohort on their journeys as early career researchers. Here is their take on the pilot grant experience and what they are working towards next:

Ali Jalali joined the Division of Comparative Effectiveness & Outcomes Research at Weill Cornell Medicine as a postdoctoral associate in 2019 and was promoted to assistant professor in April 2021.

Ali Jalali, PhD, MA

Ali Jalali’s research will be the first study to provide Medicaid healthcare resource unit cost estimates for pregnant women with opioid use disorder and their infants.

How has this pilot grant shaped or supported your career?

The CHERISH pilot grant provided financial support for me to pursue timely research and develop expertise in the field of addiction and substance use disorder treatment and policy. CHERISH organized multiple avenues and virtual events in the past year for early career investigators like myself to network and build a mentorship group with CHERISH Research Affiliates and investigators. Effective mentorship and access to a network of interdisciplinary scholars is invaluable at this stage in my academic career.

What’s next after the pilot grant?

I am excited to complete my pilot grant research aims and disseminate the findings through scientific publications and with support from the CHERISH Dissemination and Policy Core. I hope that early results of my research—made possible through the CHERISH pilot grant—will continue to advance my academic career at Weill Cornell Medicine.

Austin Kilaru completed the National Clinical Scholars Program and is a new senior fellow at The Leonard Davis Institute of Health Economics at the University of Pennsylvania and Assistant Professor of Emergency Medicine at the University of Pennsylvania Perelman School of Medicine.

Austin Kilaru, MD, MSHP

Austin Kilaru’s pilot study examines adherence to medications for opioid use disorder, such as buprenorphine and methadone, following an opioid related emergency department visit.

How has this pilot grant shaped or supported your career?

The experience has opened the often siloed work that can happen in my specialty, and it brought together investigators with similar interests from different institutions together. The research becomes more feasible and fun, like we’re all pulling together intellectual and analytical firepower. I was able to learn from collaborators like Yuhua Bao and fellow pilot grant recipient Hao Zhang. It shows when you work with other people – it strengthens your research.

What’s next after the pilot grant?

In addition to completing my pilot project, I am applying for a NIDA career development award as a new faculty member at Penn—the CHERISH pilot work has deeply shaped my future research plans. I’ll also be mentoring a recipient of the next CHERISH pilot cycle, Dr. Ravi Gupta.

Hao Zhang completed his post-doc and is now a research associate in the Division of Comparative Effectiveness & Outcomes Research at Weill Cornell Medicine.

Hao Zhang, PhD

Hao Zhang’s pilot study evaluated prescription drug monitoring programs and identified potential unintended consequences for patients with sickle cell disease and boney cancer pain. He presented his study at the 2021 Annual Research Meeting by Academy Health and published his research in JAMA.

How has this pilot grant shaped or supported your career?

The whole process—from grant application to data management and analyses and collaboration with co-authors from external institutions—was new to me. This project was the first time that I served as a principal investigator. Through the process I became familiar with the grant application procedure, enriched my research and publication experiences, and gained insight on the impact of prescription drug monitoring programs among different populations.

What’s next after the pilot grant?

This pilot grant is primarily exploratory, and the findings lay the groundwork for formal evaluation of opioid policies among the population of cancer patients. My supervisor Dr. Yuhua Bao has an R01 grant application currently under review that further explores these questions. We will use claims data from Health Care Cost Institute and SEER-Medicare to investigate the impact of opioid policies on opioid use and opioid-related adverse events among clinically important subpopulations of breast, prostate, colorectal, and lung cancer patients.

Pilot Grant Recipients Receive Funding to Examine Health Disparities Related to the Treatment of Substance Use Disorders, HCV, and HIV

Profile image of Shoshana Aronowitz

Follow Shoshana Aronowitz, PhD, MSHP, FNP-BC, on Twitter @shoshiaronowitz.

Shoshana Aronowitz, PhD, MSHP, FNP-BC

Shoshana Aronowitz is a family nurse practitioner, community-engaged health services researcher, and assistant professor in the Department of Family and Community Health at the University of Pennsylvania School of Nursing. Her research examines innovative delivery models to promote equitable access to substance use treatment and harm reduction services, as well as racial disparities in pain management in the context of the opioid overdose crisis. In one of her latest publications, she evaluated a partnership between two community-based organizations and the Philadelphia Department of Public Health that provide free mailed naloxone kits and other harm reduction supplies to Philadelphians.

With the guidance of the CHERISH Dissemination & Policy Core Director Zachary Meisel and CHERISH Research Affiliate Laura Starbird, Aronowitz’s pilot project, “An Exploration of Barriers and Facilitators to Buprenorphine Access via Telehealth,” will study low-barrier treatments for substance use disorder and expand healthcare services to marginalized populations who use drugs.

Aronowitz provides opioid use disorder treatment at Prevention Point Philadelphia and Ophelia Health and is a harm reduction community organizer with SOL Collective. She received her undergraduate degree from McGill University and earned her master’s and doctoral degrees from the University of Vermont and University of Pennsylvania. She completed her postdoctoral fellowship at the National Clinician Scholars Program University of Pennsylvania site.

Profile photo of Ravi Gupta

Follow Ravi Gupta, MD, on Twitter @rgupta729.

Ravi Gupta, MD

Ravi Gupta is an internal medicine physician and National Clinician Scholars Program fellow at the University of Pennsylvania. His research focuses on evaluating policies on the use of prescription drugs and has been published in several high-impact journals. Notably, his investigation into rising naloxone prices led to congressional investigations of companies that manufacture naloxone.

Under the mentorship of the CHERISH Dissemination & Policy Core Director Zachary Meisel and former pilot grant recipient Austin Kilaru, Gupta’s pilot project, “Adoption of Extended-Release Buprenorphine Monthly Injections for Opioid Use Disorder,” will allow him to further examine the potential of extended-release buprenorphine and how racial disparities influence treatment adherence for people with opioid use disorder.

He received his undergraduate degree from Ohio State University, graduated from Yale School of Medicine, completed his clinical residency at Johns Hopkins Hospital in the Urban Health track, and practices medicine at the Corporal Michael J. Crescenz VA Medical Center.

Profile image of Thanh Lu

Follow Thanh Lu, PhD, on Twitter @thanh2lu.

Thanh Lu, PhD

Thanh Lu is a postdoctoral researcher in the Division of Comparative Effectiveness and Outcomes Research in the Department of Population Health Sciences at Weill Cornell Medicine and a CHERISH Research Affiliate. Lu has robust expertise in conducting economic analyses with a range of data sources including emergency department encounters, hospital discharge records, and surveys. One of her recent publications examined the relationship between recreational marijuana laws and household spending on food and alcohol.

Under the guidance of CHERISH Methodology Core Co-director Sean Murphy and Yiye Zhang, assistant professor in the Department of Population Health Sciences, Lu’s pilot project, “Stimulant Use Disorder Treatment Paths and Factors Contributing to Health Disparities,” will allow her to identify driving factors that exacerbate health disparities in treatment outcomes related to stimulant use disorder and address the emerging public health concern of stimulant-related overdoses.

Lu received her undergraduate degree from the Clarion University of Pennsylvania and graduated from Temple University with a master’s and doctoral degree in economics.

Follow Xiao Zang, PhD, on Twitter @XiaoZang5.

Xiao Zang, PhD

Xiao Zang is a postdoctoral research associate in the Department of Epidemiology at Brown University where he has demonstrated expertise in disease simulation modeling, model calibration, and health economic evaluation. Working with his postdoctoral supervisor CHERISH Research Affiliate Brandon Marshall, Zang has led valuable research projects including examining the impact rural syringe service program closures have on the HIV epidemic in Indiana, and the development of a microsimulation model to inform community-level naloxone distribution strategies to minimize opioid overdose fatalities.

With the mentorship of Marshall, Zang’s pilot project, “Improving Health Equity and Naloxone Access Among People at Risk for Opioid Overdose: A Distributional Cost-Effectiveness Analysis of Community-Based Naloxone Distribution Strategies,” will offer him an opportunity to evaluate and improve naloxone access for different racial and ethnic groups.

Zang received his undergraduate degree from Southeast University in China and a master’s degree in industrial and systems engineering from the University of Southern California. He earned his doctoral degree in health sciences from Simon Fraser University in Canada.

Ali Jalali, Hao Zhang and Austin Kilaru Awarded Sixth Cycle of CHERISH Pilot Grant Funding

Ali Jalali, PhD

Dr. Ali Jalali is a Postdoctoral Associate in the Department of Population Health Sciences at Weill Cornell Medical College. He completed his doctorate in economics at the University of Utah. His current research focuses on economic evaluations of interventions for substance use disorders and related conditions. His pilot grant will examine healthcare resource utilization patterns and Medicaid costs for pregnant women with opioid use disorder, infants with and without exposure to opioids in utero, and infants with and without neonatal opioid withdrawal syndrome (NOWS). He will use data from the Medicaid and Children’s Health Insurance Program (CHIP) Transformed Medicaid Statistical Information System (T-MSIS), which will provide the opportunity to generate nationally representative Medicaid unit costs for healthcare services. This study will address knowledge gaps regarding pregnant women with opioid use disorder and their infants, and will be the first study to provide Medicaid healthcare resource unit cost estimates for these women and infants for future economic evaluations.

Hao Zhang, PhD

Dr. Hao Zhang is a Postdoctoral Associate in the Department of Population Health Sciences at Weill Cornell Medical College. He completed his doctorate in health services research at Texas A &M University focusing on econometric models and policy analysis. His current research centers on evaluating opioid-related policies and his pilot grant will examine the effect of changes in opioid prescribing practices on patients with metastatic bone cancer and patients with sickle cell disease who may be undertreated for pain. His study will assess trends in rates of emergency department visits, emergency department initiated opioid prescriptions, and costs among these populations using the Health Care Cost Institute (HCCI) claims database, a national dataset of commercially insured and Medicare Advantage individuals. This study will generate new knowledge regarding pain management, access to opioid therapies, and costs among patient populations at risk for under treated pain.

Austin Kilaru, MD, MSHP

Dr. Austin Kilaru is a Fellow in the National Clinicians Scholars Program and Attending Physician in the Department of Emergency Medicine at the University of Pennsylvania, and an Associate Fellow at the Leonard Davis Institute of Health Economics. As part of his fellowship he has received training in health services research and his research has focused on financial incentives to improve on opioid use disorder treatment systems within hospitals. His pilot grant will examine adherence to medications for opioid use disorder (buprenorphine and methadone) following an opioid related emergency department visit. He will explore the association between adherence and co-payment or out-of-pocket costs and the association between treatment discontinuation and repeated opioid-related emergency department use. He will use the Optum Clinformatics Datamart, a national commercial claims dataset. This study will have policy implications for payers and providers that seek to expand access to opioid use disorder treatment.

Angelica Meinhofer, Margaret Lowenstein and Rachel Epstein Awarded Fifth Cycle of CHERISH Pilot Grant Funding

Angelica Meinhofer, PhD

Dr. Angelica Meinhofer is an Instructor in the Department of Healthcare Policy & Research at Weill Cornell Medical College. She completed her doctorate in Economics at Brown University and previously worked as a Research Economist at RTI International’s Behavioral Health Services, Policy and Economics Research Program where she designed and conducted evaluations of interventions for opioid use disorder. Her pilot grant will examine the impact of punitive and supportive pre-natal drug use policies on maternal behaviors, pregnancy outcomes, and costs using national data sets. Using CHERISH funds she will purchase the Healthcare Cost and Utilization Project (HCUP) data set, which includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information. This study will address critical knowledge gaps regarding the impact of state policies for reducing substance use during pregnancy, and will guide policy approaches to improve maternal and infant health.

M. Lowenstein
Margaret Lowenstein, MD, MPhil

Dr. Margaret Lowenstein is a Fellow and VA Scholar in the National Clinicians Scholars Program at the University of Pennsylvania and an Associate Fellow at the Leonard Davis Institute of Health Economics. As part of her health services research fellowship, Dr. Lowenstein’s research focuses on access to harm reduction and substance use treatment for people with opioid use disorders. Her pilot grant will estimate the cost and effectiveness of naloxone distribution to prevent overdose fatalities in public libraries in Philadelphia from a city policymaker perspective. This study will be among the first to examine overdose outcomes, costs and cost-effectiveness of naloxone distribution in public institutions and the first to evaluate naloxone distribution efforts in public libraries. Libraries represent an innovative model for scaling up community-based overdose prevention efforts and are a promising part of comprehensive strategies to combat the opioid crisis. The results from her pilot study will inform policymakers about the best use of scarce resources to reduce overdose mortality and increase access to naloxone.

R. Epstein
Rachel Epstein, MD, MS

Dr. Rachel Epstein is a Postdoctoral Research Fellow in Infectious Diseases and Pediatric Infectious Diseases at Boston Medical Center. She previously completed a combined fellowship in adult and pediatric infectious diseases while completing an MS in Epidemiology from the Boston University School of Public Health. Her previous research has largely focused on characterizing the HCV care cascade for people with substance use disorder, and HIV medication adherence and prevention. With pilot grant funding from CHERISH, Dr. Epstein will be able to access the MarketScan commercial claims dataset and link these data with a novel dataset of Medicaid HCV treatment policies maintained by the National Viral Hepatitis Roundtable and the Center for Health Law and Policy Innovation of Harvard Law School. This will enable her to analyze HCV screening, linkage, and treatment rates by state and compare the trends in outcomes among states maintaining more restrictive HCV treatment Medicaid policies to those that decreased restrictions over the study period. Her pilot grant will provide important information regarding unintended (or “spillover”) effects from Medicaid policies to commercial payers that could have future implications for the treatment policy landscape. 

Katherine Wen and Melissa Zielinski, PhD Awarded CHERISH Enhancement Funding

Katherine Wen is a doctoral student in the Department of Policy Analysis at Cornell University. Ms. Wen is working with CHERISH Research Affiliate and Cycle 1 Pilot Grant recipient, Dr. Yuhua Bao, to assess the effects of state policies and practices aimed at improving prescriber use of Prescription Drug Monitoring Programs (PDMPs) on opioid prescriptions that put patients at high risk of opioid misuse and overdose (“high-risk opioid prescriptions”). With CHERISH enhancement funding, Ms. Wen will use Health Care Cost Institute (HCCI) data to assess the effects of PDMP policies on opioid overdose and other opioid-related inpatient admissions and emergency department (ED) visits with a focus on the privately insured and Medicare Advantage populations. Findings of this study will inform future policy-making for safe prescribing of pain medications for effective management of pain.

Dr. Melissa Zielinski is an Assistant Professor of Psychiatry at the University of Arkansas. She completed a PhD in Clinical Psychology from the University of Arkansas and pre-doctoral internship and post-doctoral fellowship in Addiction Research at the University of Arkansas Medical Sciences. Dr. Zielinski serves as the evaluator for the Pulaski County Regional Crisis Stabilization Unit (PCRCSU), one of Arkansas’ four state-mandated crisis stabilization units intended to aid in diverting people who come into contact with police due to acute mental health crises from jails and into a medically-appropriate level of care. Dr. Zielinski, CHERISH Research Affiliate Dr. Joshua Barocas, and colleagues will use CHERISH enhancement funding to conduct a preliminary economic evaluation of the PCRCSU to provide timely information on the budget impact of the unit to the state of Arkansas as it considers expanding the number of units throughout the state.

Tyler Bartholomew and Shashi Kapadia, MD, MS Awarded Fourth Cycle of CHERISH Pilot Grant Funding

Tyler Bartholomew is a doctoral student in the Department of Public Health Sciences at the University of Miami. Prior to entering the doctoral program, he was the project manager for an HIV and HCV testing, linkage to care, and treatment program at five federally-qualified health centers in Philadelphia, Pennsylvania as part of his AmeriCorps service. For his pilot grant, he will conduct an economic analysis of Florida’s Infectious Disease Elimination Act (IDEA) Syringe Exchange Program located in Miami. Using clinical data from IDEA Exchange participants, he will estimate the costs of the IDEA fixed syringe exchange program and the mobile syringe exchange program from the healthcare and societal perspectives. He will also estimate the cost of ancillary services such as naloxone distribution and an onsite wound care clinic. The results of his pilot study will support the evaluation of broader implementation of syringe exchange services across the state Florida.

Dr. Shashi Kapadia is an instructor in Medicine and in Healthcare Policy & Research at Weill Cornell Medicine; he previously completed an Infectious Diseases Fellowship, a Public Health and General Preventive Medicine Residency, and his Masters of Science in Clinical Investigation at Weill Cornell. In his pilot grant, he will use a national administrative dataset to characterize changes in the Hepatitis C (HCV) provider landscape, comparing the period before direct acting antivirals (DAAs) and after DAAs. Using this dataset, he will assess the changes in the number and types of providers offering HCV-testing and treatment, examine the HCV testing and treatment volume across providers, and compare the rate of treatment completion for patients treated by providers with different volumes. He will evaluate results for all HCV patients and for HCV patient subgroups with opioid use disorder diagnoses and with HIV co-infection.