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Center for Health System Sustainability

Center for Health System Sustainability

Real-world data for global health policy.

Center for Health System Sustainability

Real-world data for global health policy.

At the Center for Health System Sustainability (CHeSS), we help countries learn from one another to optimize patient care and build resilient and sustainable health systems. We do so by leveraging patient-level data and global partnerships to produce comparative data insights and actionable policy recommendations.

About CHeSS

Powering health systems research with patient-level data through global partnership.
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Areas of Work

We learn what makes health systems high-performing, resilient, and sustainable.
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Our Data Network

International Collaborative for Costs, Outcomes, and Needs in Care (ICCONIC)
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https://www.youtube.com/embed/7wBK4II5N_A

CHeSS asks

 

What is the biggest issue with the RI healthcare system?

CHeSS: A new center at Brown to study health care systems across countries

A discussion comparing health policy challenges facing the U.S. to those faced by other high-income countries illustrated how the Center for Health System Sustainability aims to improve health care systems through research.

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The Latest at CHeSS

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JAMA Network

Lowering Drug Prices in the US—Look Within, Not Abroad

July 28, 2025
On May 12, 2025, the Trump administration issued an executive order to lower prescription drug costs by mandating that the US pay no more than prices in peer countries. The legality of implementing this so-called most favored nation (MFN) pricing through executive action is unclear. However, the idea of benchmarking US drug prices to prices in other countries is not new. The Trump administration unsuccessfully attempted a more limited MFN policy during its first term, and a 2019 bill passed by House Democrats used international prices as upper limits for Medicare price negotiations. Although lowering drug prices is a priority, achieving this by linking prices in the US to those in other countries is a misguided approach built on a misdiagnosis of the reason prices are higher in the US than in other countries.
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The New England Journal of Medicine

Response to the Editors - Wealth and Mortality in the United States and Europe

July 9, 2025
The responses to our study on wealth and mortality in the United States and Europe raise important questions about causal inference, potential confounding, and the interpretation of cross-national differences. As noted by the correspondents, our findings reflect associations, not causal relationships. Although the patterns we observed were consistent across settings, more work is needed to disentangle the complex relationship between wealth and health.
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Health Affairs

New Cancer Drug Approvals: Less Than Half Of Important Clinical Trial Uncertainties Reported By The FDA To Clinicians, 2019–22

July 7, 2025
Uncertainties about the benefits and harms of new drugs are common at the time of drugs’ approval. It is unclear to what extent the Food and Drug Administration (FDA) communicates these uncertainties in the FDA-approved prescribing information (the drug label), which is the primary channel of communication between the FDA and physicians. Although physicians might not regularly consult the drug label for prescribing decisions, other information sources used by physicians either index or incorporate information from the label. We searched FDA review documents for uncertainties identified by FDA reviewers with new cancer drugs. We considered the subset of uncertainties highlighted in the FDA’s Benefit-Risk Framework as important to the FDA’s approval decision. During the period 2019–22, the FDA approved fifty-two new cancer drugs. In review documents, FDA reviewers identified a total of 213 clinical trial uncertainties with new cancer drugs, 50 percent of which were considered to be important uncertainties to the FDA’s approval decision. Labels for physicians reported information on 26 percent of all uncertainties and 48 percent of uncertainties that were important to the FDA’s approval decision. Communicating uncertainties about the evidence of drugs in the label is essential for informing physicians about drugs’ safe and effective use.
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Upcoming CHeSS events

Harmonizing International Health Data for Better Outcomes

Professor Irene Papanicolas joins Megan Hall on the Humans in Public Health podcast to discussed her work: she aims to standardize data from across global health systems and compare them in order to inform policy choices and improve health care value and patient care.

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Brown University School of Public Health
Providence RI 02903 401-863-3375 public_health@brown.edu

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