As one formulary decision-maker told us: “Recent regulation guidance on FDAMA114 frees up pharma to be more active in sharing HEOR information, and I think that helps.”

That regulatory development—and the payer’s sentiment—point the way to important communication opportunities for pharma brands. It is now incumbent upon market access teams to make the most of those opportunities.

The fact is, payers are increasingly factoring HEOR data into their coverage decisions, and the influence of independent HEOR assessment organizations (like ICER and others) is beginning to take hold. Outcomes data can serve as the basis for value-based contracts and can also demonstrate a drug’s ability to help meet established quality measures. Such benefits are key at a time when the healthcare paradigm is evolving toward value-based reimbursement and more aggressive cost-sharing models.

All of this suggests that HEOR—correctly packaged—can be a potent tool for pharma market access teams seeking to bolster their value stories. The challenge of telling those stories effectively, however, should not be underestimated. The cumbersome formats of these complex analyses can be counterproductive when trying to communicate efficiently with busy formulary decision-makers. In addition, we have heard payers express frustration that they are not consulted during the study design phase and that HEOR endpoints are not aligned with their information needs.

Considering the reality of these obstacles—and the significance of the opportunity—it is imperative for pharma companies to a) develop HEOR data that targets payer concerns and b) convey HEOR data in audience-friendly ways so that payers grasp, value, and apply the information.

Market access teams and their agency partners can accomplish this by:

  1. Assessing evidence gaps (from the payers’ perspective) early on, preferably before launch, so that they are delivering the outcomes data that are most likely to move the access needle.
  2. Fully integrating their analytic and storytelling capabilities in seamless collaboration.
  3. Inventing reproduceable best practices (language, formats, and formulas) in HEOR communications and helping the audience become familiar with these.
  4. Leveraging what they know about payer preferences with regard to other types of communication, and drawing upon the full communications toolbox.

The ultimate objective is to find relevant meaning in HEOR data and distill it to its essence.

Meeting these challenges—and capitalizing on these opportunities—requires strategic and purposeful communications from pre-launch to post market. Those who aren’t rising to the task today, better hurry.

  • Amber Gilbert

    Amber Gilbert is Managing Director at Cyan Health. Amber has helped biopharmaceutical companies develop successful pricing, access, and reimbursement strategies and programs in support of product launches for major specialty and chronic conditions. She is also a frequent lecturer at Rutgers Business School and has presented original research at AMCP. 

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