Health economics and outcomes research is often more scientifically focused than other market access-related functions. As a result, some companies have separated HEOR from pricing and reimbursement. Figure 1 below shows that 29 percent of companies now house HEOR under medical affairs, away from the more commercially oriented pricing and reimbursement functions. When Cutting Edge Information last surveyed HEOR teams in 2010, the data showed only 10 percent of companies with this structure.
Proponents of the move to medical affairs argue that medical affairs has a greater focus on medical and clinical findings than commercial teams. This focus allows health economics teams to truly concentrate on the science of the molecule rather than the commercial promise of the brand. This structure also provides a closer link to medical information and publications teams — valuable outlets for HEOR messages.
As with any structure, however, the medical affairs alignment presents challenges for HEOR teams. The largest challenge is that teams located under medical affairs conduct their research work with an eye toward the scientific findings rather than the economic potential. This tendency has the potential to limit the commercial impact of the HEOR messages. Since the health outcomes message can drive the overall market access strategy, not having a commercially oriented focus can slow the brand’s revenue uptake.
According to one director of health economics at a U.S. biotech company, “It doesn’t really matter where you sit because the whole discipline — like everything in the pharma world — is to sell drugs. Whether you sit in marketing or medical affairs, you have to be completely honest in what you do. The payer will see right through you. If you only focus on the data that you like, it’s going to come back and hit you in the end. The data is the data, and it doesn’t matter which department sponsors it.”
The strategic move to medical affairs suggests that, for many companies, HEOR’s natural links to medical affairs are stronger than those to commercial operations. For now, at least, health economics and outcomes research will likely be more data-focused.