HEOR

What is HEOR (Health Economics and Outcomes Research)?

HEOR (Health Economics and Outcomes Research) is a scientific discipline used to generate evidence on the clinical, economic, and humanistic value of medical products and interventions. It goes beyond traditional clinical trial data (which proves safety and efficacy) to demonstrate how a drug or device performs in a real-world setting and its overall impact on the healthcare system.

Context & Strategic Role

In today's value-based healthcare environment, HEOR is no longer a "nice-to-have" but a critical function for achieving market access and commercial success. Payers, Health Technology Assessment (HTA) bodies, and organized providers use HEOR data to make crucial decisions about pricing, reimbursement, and formulary placement. Strategically, a strong HEOR function proves that a new product is not just clinically effective but also economically viable and beneficial to patient quality of life, justifying its cost to budget-holders.

Core Functions / Pillars of HEOR

The core responsibilities of an HEOR team are centered on evidence generation and synthesis:

• Real-World Evidence (RWE) Generation: Designing and conducting studies using real-world data (RWD) from sources like electronic health records (EHRs), patient registries, and insurance claims to understand treatment patterns and outcomes in routine clinical practice.

• Economic Modeling: Building sophisticated models (e.g., cost-effectiveness, budget impact models) to forecast the financial impact of a new therapy on a health system's budget.

• Patient-Reported Outcomes (PROs): Developing and implementing studies to capture the patient's perspective on their health, quality of life, and treatment burden.

• Value Dossier Development: Compiling all clinical, economic, and humanistic evidence into a comprehensive document (the value dossier) to submit to payers and HTA bodies for reimbursement negotiations.

Lifecycle & Practical Impact

HEOR activities begin in early-stage development to inform clinical trial design and continue throughout the product lifecycle. However, its impact is most critical during the pre-launch and post-launch phases. The evidence generated by HEOR studies directly influences whether a drug will be included on a national or regional formulary. A lack of compelling HEOR data can lead to restricted access, unfavorable pricing, or outright rejection by payers, severely limiting a product's potential.

Success Metrics / KPIs

The success of an HEOR strategy is measured by tangible market access outcomes:

• Positive recommendations from HTA bodies (e.g., NICE in the UK, IQWiG in Germany).

• Favorable formulary placement and minimal reimbursement restrictions.

• Successful pricing negotiations with national and regional payers.

• Publication of HEOR studies in high-impact, peer-reviewed journals.

TikaMobile Relevance

While HEOR focuses on data generation, the dissemination of that data to key stakeholders is crucial. Medical Science Liaisons (MSLs) are often responsible for presenting complex HEOR data to payers and influential KOLs. TikaMobile's Medical Affairs CRM empowers MSLs to have these high-impact conversations by providing mobile access to approved HEOR materials, capturing insights from these discussions, and ensuring all interactions are documented in a compliant manner. This creates a critical feedback loop that can inform future HEOR strategy.