The Society of Medical Decision Making (SMDM) Lee B. Lusted Student Awards recognize outstanding student poster presentations at the SMDM Annual Meeting. Sam Hirniak (BMath’17 and University of Waterloo School of Pharmacy PhD student) was awarded the 2024 Milt Weinstein Award for Outstanding Presentation in Applied Health Economics. In this competition, top graduate students and post-doctoral researchers worldwide compete with their abstracts, published posters, and oral presentations. Hirniak’s presentation, Cost-effectiveness of efanesoctocog alfa (EA) prophylaxis in people with hemophilia A, determined that while this new hemophilia medication provides a potential benefit for health-related quality of life, it is too expensive to enter the Canadian market.
“I am thankful to have competed in this competition for the second time,” Hirniak says. “I’ve learned a lot from my fellow competitors and society members. This conference always supports young researchers looking to start their career in medical decision-making.”
From Waterloo Math to Waterloo Pharmacy
Hirniak’s interest in research began during her undergraduate degree at the University of Waterloo Faculty of Math. Hirniak was part of the International Genetically Engineered Machine Team (iGEM) for three years during her undergrad at Waterloo. Dr. Brian Ingalls, a professor in the Department of Applied Mathematics at the University of Waterloo, inspired Hirniak to study math, something that naturally came to her.
During a brief time working in the insurance sector, Hirniak kept thinking about returning to her passion for research.
“It was Dr. Ingalls that brought me back to Waterloo,” Hirniak says. “I spoke with him about my continued interest in math and biology research and he suggested I speak to Dr. Andrea Edington at the University of Waterloo School of Pharmacy, to learn more about her mathematical modelling research.”
Hirniak reflects on the importance of aligning her goals and values with her research supervisors.
“I wanted to find like-minded people who want to better our healthcare system – I found that in Dr. Edginton and Dr. Wong and started my MSc in Pharmacy shortly after,” Hirniak says.
Hirniak is now pursuing her PhD in Pharmacy, co-supervised by Waterloo Pharmacy’s Dr. Edginton, Hallman Director and professor, and Dr. Wong, associate professor at Waterloo Pharmacy.
Deep dive into research and policy
Hirniak always wanted to combine her love for math and modelling to benefit society. Her work in hemophilia research brings her passions together. She explores whether new drugs are worth the cost to the healthcare system compared to the benefits they will provide patients.
“In Canada and Ontario, in order for a drug to be paid for with public money, a cost-effective analysis must be completed before funding can be approved – this is where our work comes in,” she says.
Hirniak creates a simulation of a population, observes how each simulated person goes through the medication, how they experience negative side effects, what the long-term potential health outcomes are, and reviews the cost analysis.
“I build a model that is meant to simulate a patient's entire life cycle with the disease, from diagnosis and beyond. I look at their health outcomes in terms of health-related quality of life and costs,” she says.
Through use of mathematical modelling to explore the effectiveness and cost of medications, the results can be used in policy-making decisions at the Canadian Drug Agency and Canadian Blood Services. Policymakers can then advocate for more appropriate drug pricing across the country, directly impacting patient health and our healthcare system. Additionally, mathematical modelling is more cost-effective and a quicker method to complete studies than running long-term real-world studies which would take decades to complete.
“Just because a medication is new and offers good health benefits, doesn’t mean it’s worth the cost for the patient or the healthcare system,” Hirniak says.
Her main thesis focuses on evaluating novel gene therapy treatments for hemophilia A. She is conducting a large evaluation of all the medications available for these patients using mathematical modelling.
“This award has given me a lot of confidence in my research,” she says. “It’s confirmed how important this research is and my capabilities. My dream is to have a big impact on health policy in the future.”
Hirniak thanks the whole Waterloo Pharmacy research team and the administrative staff. Hirniak received the following grants that contributed to this research: the University of Waterloo Graduate Studies and Postdoctoral Affairs (GSPA) grant and the Waterloo Pharmacy Christine and David Edwards. She also received the Waterloo Pharmacy Donald J and Kathleen McDougall community service award and the University of Waterloo Provost Doctoral Entrance Award (PDEA) for women.