|118 Charts and Diagrams|
Robust health economics data and convincing product value stories that sufficiently address payer needs are the new foundation of product success. Without a strong pharmacoeconomic case, a product’s reimbursement profile will be weakened, and peak sales performance will suffer. This study explores how companies identify payer needs through market research and then meet those requirements with targeted studies. The report’s benchmark data show how much time and money companies are spending on their health economics studies. Furthermore, it guides companies in making sure that HEOR resources are being allocated wisely as well as ensuring that the studies produce the desired outcomes.
Dedicated HEOR teams provide the advantage of coordinating both prospective and retrospective HEOR activities. The report’s case studies of real companies’ HEOR organizational structures illustrate how to most effectively manage pharmacoeconomic activities. Metrics include total HEOR budgets, sources of funding for HEOR activities, and funding allocation between compounds in development and marketed brands.
HEOR teams can use the insights in this report to develop winning cases that demonstrate product need to payers. Use the benchmarks in this study to align your team with product goals, allocate the team’s resources and focus on pharmacoeconomic studies that produce the desired outcomes.
Balance short-term approval needs with long-term market access and payer needs: Teams face challenges in communicating the importance of HEOR prior to launch, and resource prioritization is an obstacle. Botched launches in major markets can ripple through the entire market access budget. Building World-Class HEOR Teams examines how to structure and resource HEOR groups effectively. Dedicated teams provide the advantage of coordinating both prospective and retrospective HEOR activities. The study also includes case studies of real-company HEOR organizational structures; these examples also show how to most effectively manage vendors for HEOR activities. Metrics include total HEOR budgets, sources of funding for HEOR activities, and funding allocation between compounds in development and marketed brands.
Use the right HEOR studies to build understanding of what is driving patient needs — and to address payer requirements: Getting an early start on developing the health economics plan for a product is crucial in meeting payer needs. Identifying comparators and understanding the competitive landscape at launch can be difficult in early phases — but groups are still able to conduct research that lays the groundwork for a product’s future success on the market. Once launch approaches and HEOR involvement reaches its peak, companies should know how many studies are required to support a product effectively, as well as the potential budgetary pressures that come with addressing payer concerns. This report guides companies in making critical decisions and planning surrounding HEOR studies and their costs. Benchmarks include how many health economics studies are conducted and their cost and duration.
Plan to increase health outcomes liaison (HOL) headcounts as payers demand more detailed information: The study examines HEOR team staffing as well as the activities and strategies that impact their operations. Research highlights staffing numbers across central global groups and affiliate-level HEOR teams as well as compensation structure for individual team positions. Interviewed executives explain the rising need, and increased role, for health outcomes liaisons (HOLs) to discuss pharmacoeconomic data with payers as part of a compelling value story. Other data demonstrate the core activities driving strategy across HEOR groups as well as perceived impact of health economics and outcomes data for specific payers’ formulary decisions. Altogether, the information in this report helps companies build skilled, focused HEOR teams capable of adjusting to payer needs throughout the product lifecycle.
This chapter contains 47 charts. Data are often broken down by company size/type (top 10, top 50, top 10 and top 50 affiliate, small and medical device) and group type/focus of responsibility (central global groups, US, EU, Canada, and emerging markets, country-level affiliates).
HEOR Team Structure
HEOR Funding, Spending and Budgets
HEOR Challenges and Performance Measurement
This chapter contains 28 charts. Data are often broken down by company size/type (top 10, top 50, top 10 and top 50 affiliate, small and medical device) and group type/focus of responsibility (central global groups, US, EU, Canada, and emerging markets, country-level affiliates).
HEOR Team Staffing
HEOR Activities and Their Impact on Payers
This chapter contains 41 charts. Data are often broken down by company size/type (top 10, top 50, top 10 and top 50 affiliates, small and medical device) and group type/focus of responsibility (central global groups, US, EU, Canada, and emerging markets, country-level affiliates).
24 charts detailing 6 HEOR group profiles. Consisting of infographics, each profile contains information on the HEOR group’s structure, staffing and spending, and studies conducted.
HEOR Structure and Spending
Staffing and Activities
Health Economics Studies and Expenditures
The following excerpt is from Chapter 2, “Staffing HEOR Teams for Strategic Operations.”
Health economics teams typically have the human resources to product compelling data, but disseminating this information to payers can be a challenge. HEOR team members have the best understanding of these data; however, MSLs and sales reps have higher levels of contact with key accounts. To ensure that key payers receive the best possible presentations of HE data, many teams — especially those small HEOR groups — are looking to expand their HOL teams.
A Company D vice president noted the need for HOLs on his country-level team. While the Top 50 company’s US-based group is small now, the vice president hopes to add two to three outcomes liaisons to the US-based HEOR team. Currently, the HEOR group looks to MSLs to step into the outcomes liaison role when possible.
Company E also hopes to add to its HEOR resources in the next year. “You can always do more with more people,” explained one Company E HEOR director. Company E currently relies on its HEOR director and a senior scientist to make presentations in the field. The director hopes to add HOLs to take on this responsibility. “I think over the next few years, we’ll see a continued use of well-trained HOLs to present technically difficult information and distill it to make a good value argument — especially for managed markets and national accounts.” As Company E prepares to launch a new product, the HEOR director hopes that HOLs are on the horizon. Ideally, the team would take on 4 new FTEs to divide the US into quadrants. When the company is ready to hire HOLs, the director plans to look for individuals with high levels of clinical and financial knowledge, as well as some type of economic training.
Matching HOL headcounts to group workload can be a daunting challenge for teams hoping to expand. While budgets are certainly one constraint, HEOR teams must consider other factors as well. An interviewed senior director at Company A, a Top 10 biotech firm, explained that product portfolio and customer base played a large factor in establishing their high HOL headcount. The executive noted, “If you take the breadth of our portfolio and the knowledge depth of what’s involved and you take the customers we have to service, our HOL team is not large; it’s right-sized. Team size depends on the dedicated customer base you’re going after.”
The director also noted that, in some companies, the HOL role is taken on by MSLs. However, in his company, which has a broad portfolio covering large populations, specialized field forces are better equipped to work with their 1,000-plus payer accounts.
The following excerpt is a key finding taken from the full report's Executive Summary.
Health economics and outcomes research is arguably more clinical or medical in nature than other market access-related functions. As a result, some companies separate HEOR from pricing and reimbursement. Many locate HEOR under medical affairs, away from the more commercially oriented pricing and reimbursement functions. Figure E.1 [Figure included in Full Report] shows that 29% of companies now house HEOR under medical affairs. When Cutting Edge Information last surveyed HEOR teams in 2010, this percentage was only 10%.
Proponents of the move to medical affairs argue that medical affairs has a “higher focus on integrity” than commercial teams. This focus allows health economics teams to truly concentrate on the science surrounding the brand, not its commercial promise. Also, it provides a closer link to medical information and publications teams — valuable outlets for HEOR messages.
However, as with any structure, the medical affairs alignment presents challenges for HEOR teams. The largest challenge is that teams located under medical affairs are more academic in nature, researching the data for the data’s sake. This tendency can sometimes limit the commercial impact of the HEOR messages. Since the HEOR messages drive the overall market access strategy, not having commercially oriented messages can stunt the brand’s revenue stream.
According to the director of health economics at a US 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.”
Even so, HEOR’s move to medical affairs suggests that for many companies, the ties to medical affairs are stronger than those to commercial. For now, at least, the teams will be more research focused.