As a part of our “Meet Yale Internal Medicine” series, today’s feature is on Reshma Ramachandran, MD, MPP, MHS, assistant professor of medicine (general medicine.)
Reshma Ramachandran, MD, MPP, MHS, not only believes in equitable access to healthcare and medical products but is a formidable force in advocating for it.
She began her journey at Brown University in their joint BS/MD program, where she initially conducted bench research within her initial field of study, physics. She was fascinated by developing technologies for patients with unmet needs and the intersection of healthcare and new nanotechnologies. Her trajectory changed between her third and fourth year of college, when she had the opportunity to work with the Medical Research Council in Cape Town, South Africa.
“In Cape Town, I was confronted with political and economic realities that were directly impacting access to treatments and patients living with HIV/AIDS. I saw firsthand how engaged civil society organizations were in advocating on behalf of patients, concerned that the high cost of these medications were clearly precluding access. The more straightforward thought I had initially – that if you develop something through a lab and a company, it would be accessible – was not true. There was this economic and political landscape, in addition to other commercial determinants, that I wasn’t aware of. This experience showed me there were groups both within and outside of medicine that were breaking down these barriers,” said Ramachandran.
Throughout medical school, Ramachandran remained interested and involved in health policy and advocacy. Through the patients she met at Brown, she saw how the challenges of affordable access to treatments problems were not only abroad, but also in her own backyard. She became involved with the American Medical Student Association working with other students and faculty on efforts to prevent monopoly price protection concessions made to the pharmaceutical industry as part of the Affordable Care Act, advocate against provisions that would bar access to affordable medicines within trade agreements, and address pharmaceutical conflicts at academic medical centers and their undue impact on medical education and prescribing. This prompted her to pursue additional interdisciplinary training at the Harvard Kennedy School where she received a master’s degree in public policy.
Prior to completing her family medicine residency at Kaiser Permanente Los Angeles Medical Center, she worked as research faculty at the Innovation + Design Enabling Access (IDEA) initiative at the Johns Hopkins Bloomberg School of Public Health. Here she focused on the global challenge of antimicrobial resistance and state-level initiatives to address unaffordable access to prescription drugs. After completing her residency, she came to Yale School of Medicine as a fellow within the National Clinician Scholars Program to receive health services research training and apply this to her interests in pharmaceutical policy. Following fellowship, Ramachandran then joined the faculty at Yale School of Medicine.
“It became very apparent to me that academics could also have this large impact at a local and national level,” she states. While at Yale, she pursued research related to COVID-19 vaccine pricing and global access to COVID-19 health technologies. Additionally, she examined the practices of the U.S. Food and Drug Administration (FDA) including medical product evaluation and approval and their impact on patients, clinicians, and other stakeholders. Over the last two years, she has been called to testify before the U.S. Congress three times including on the potential ramifications for patients and public health systems on post-pandemic COVID-19 vaccine pricing, proposals meant to improve existing FDA review pathways, and pharmaceutical research and development incentives.
Her work is not done. With much momentum, she helped found the Yale Collaboration for Regulatory Rigor, Integrity, and Transparency (CRRIT), which she co-directs with Joseph S. Ross, MD, MHS.
“Now we are building this interdisciplinary network including students and trainees who are trying to solve these critical regulatory policy questions centered around improving patient outcomes and ensuring access to truly safe and effective treatments. CRRIT serves as a vehicle to translate our research into actionable recommendations for policymakers in regulatory agencies as well as Congress that protect patients above all else.”
General Internal Medicine is committed to the core missions of patient care, research, education, and community health from the “generalist” perspective and is one of the 11 sections with the Department of Internal Medicine. To learn more about their mission and work, visit General Internal Medicine.