Meet PITCH Fellow Jennifer Hwang

A graduate of Touro College of Osteopathic Medicine and a technologist in the Cytogenetics Laboratory at New York-Presbyterian/Weill Cornell Medicine for six years, PITCH Fellow Jennifer Hwang remembers a feeling of awe when she first arrived at the University of Chicago Medical Center and saw scientist Janet Rowley’s photograph on the wall in Internal Medicine. “I’m at UChicago, where Janet Rowley worked!” she recalls thinking. “As a female scientist [in the 1960s], she opened the field of cancer cytogenetics. She changed the paradigm of treatment because people now search for genetic targets to cure cancer.”

When Hwang won the Health Services/Med Ed/Social Sciences Poster Award for “Long-term Distributional Impact and Cost-Effectiveness of Tirzepatide and Semaglutide in Obesity Treatment Among US Adults” at this year’s Janet Rowley Research Day at the University of Chicago, it was a moment of pride and connection. “I always looked up to Rowley,” she says. “I heard so many inspiring stories about her.”

Though Hwang thought during her residency at the University of Connecticut School of Medicine that she would pursue a career in hematology and oncology, she discovered a passion for research during a stint as a guest researcher analyzing the cost-benefit of gout medications under PI Sung Kweon Cho in the section of Molecular Genetic Epidemiology at the National Cancer Institute/ National Institutes of Health. As an undergraduate researcher at Stony Brook University, she had designed studies demonstrating the impact of expanding quality control limits on the quantity and efficiency of routine chemistry tests. Under Dr. Cho, she found she enjoyed the teamwork and process of research as much as the knowledge the work generated. “I enjoy applying current knowledge to improve decision-making processes in healthcare,” she says. “For example, my study on the cost-benefit analysis of febuxostat versus allopurinol considered not only the statistical risks of adverse reactions like Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis but also the broader economic and social implications of these medications on the US Asian population.”

Hwang’s research at the University of Chicago combines her interests in decision science and metabolic disease. Mentored by CDRP faculty affiliate David D. Kim, she uses simulation models to analyze the cost-effectiveness of glucagon-like peptide 1 (GLP-1) agonists. These drugs, which include semiglutide and tirzepatide, mimic a hormone that reduces cravings and slows digestion, resulting in dramatic weight losses of 15-20%–at high list prices. “One of our concerns is that is this new technology will worsen health disparities,” she notes.

Using a model, Hwang projects health outcomes of GLP-1 agonist treatments over time on individuals using a nationally represented data set that weighs benefits against adverse effects. “I like the mechanics of building models,” she says. “It’s very different than what I would do as a general clinician.”

Hwang credits the PITCH Fellowship with her pivot to decision science. “I’ve learned so much: programming, applying clinical trial data to modeling, learning about decision science in general. The fellowship paved a whole new career path for me,” she says. “During my fellowship, I learned decision science is not just about analyzing data; it’s about interpreting it within the context of real-life impacts and making informed recommendations that can lead to better health policies and outcomes. My drive towards decision science is propelled by the desire to contribute to a field that not only understands the problems at hand but also actively seeks out solutions that are informed by a rigorous, analytical, and comprehensive understanding of the factors at play. I am a living experimentalist at heart. I was always interested in how people make decisions and the consequences of their decisions.”

Ultimately, Hwang’s goal is to inform policymakers and healthcare providers about the economic and clinical value of anti-obesity medications and encourage them to make evidence-based decisions that can lead to better health outcomes for the public. “I am particularly interested in how various social determinants of health—like socioeconomic status, education, cultural norms, access to healthcare, and environmental factors—influence their treatment outcomes,” she says. “Understanding that the impact of anti-obesity medications is not just a matter of pharmacological action but is also deeply intertwined with social determinants will allow us to see a more complete picture of treatment responses. For example, individuals from different socioeconomic backgrounds may experience varying levels of access to healthcare and medications, differences in health literacy, and disparate levels of support for lifestyle changes that are often required alongside pharmacotherapy.”

Hwang anticipates that factors such as diet, physical activity levels, stress, and work environments may significantly modify the response to anti-obesity medications. “My research would use methods to quantify these factors and assess their interaction with pharmacological treatment. This could involve the use of large databases to track prescription and health outcomes data, as well as patient surveys and interviews to capture the nuances of social determinants and their impact on medication adherence and effectiveness.”

“I hope to fill the gap between clinical efficacy and real-world effectiveness of anti-obesity medications by factoring in the broad spectrum of social determinants,” she says. “My goal is to inform personalized, equitable treatment strategies that account for the varied contexts in which patients live and manage their health, and to contribute to a healthcare system that is responsive to these diverse needs.”

Hwang will continue at the University of Chicago as a Pathways instructor.