SummaryAvalere identified the top trends in HEOR and key implications for life sciences companies to consider for their 2024 strategic plans.
The dynamic policy environment in the US, evolving value assessment landscape, and continued shift towards patient-centered care are impacting the evidence-generation needs of healthcare decision-makers. More than ever, manufacturers must demonstrate both the traditionally expected and novel value of their products to a variety of stakeholders, including payers, providers, patients, and now the Centers for Medicare & Medicaid Services (CMS). In response, life sciences companies are proactively utilizing health economics and outcomes research (HEOR) to drive broader business decisions such as market access strategy, clinical development, and patient-level interventions and support program development.
Avalere experts have identified the top 10 health economics and outcomes research (HEOR) trends for 2023 and beyond:
- Real-World Evidence: Real-world evidence (RWE) has an important and evolving role in the healthcare landscape. Strategically leveraging RWE further supports a product’s value, demonstrates real-world effectiveness, and expands its evidence base as a differentiator.
- Health Equity: Developing and executing plans to address health disparities and advance health equity benefits manufacturers from both a social and business perspective, and has been demonstrated to lead to improved patient access, wide-ranging positive business impacts, and better health outcomes for patients.
- Patient Heterogeneity: Real-world data show that patients have unique characteristics, health outcomes, and preferences that—if not taken into account—can amplify heterogeneous impacts. In a time of personalized medicine, healthcare stakeholders are prioritizing understanding the effects of patient heterogeneity on clinical outcomes.
- Implementation Science: Few evidence-based interventions are adopted into standard practice, and many innovative therapies face barriers to real-world adoption despite proven effectiveness. Manufacturers can serve a key role in accelerating evidence-based medicine through implementation science, which promises to integrate evidence into routine healthcare.
- Patient Engagement and Centricity in Healthcare Decision Making: Patient-centeredness is a hallmark of high-quality healthcare and is now being incorporated into all aspects of healthcare decision-making. It is increasingly important for life sciences companies to infuse the patient perspective into evidence-generation strategies.
- Artificial Intelligence: Artificial intelligence (AI) can create efficiencies in healthcare research by harnessing big data and implementing algorithms to optimize patient identification, risk prediction, and outcomes assessments. But its use must be balanced with transparent algorithms to avoid data bias and ensure strict adherence to privacy compliance rules. AI-based advances in research can translate to opportunities for the optimization of patient care through a variety of exciting avenues.
- Value Assessment: Value assessment in the US is constantly evolving. Payers are increasingly using value assessment results to inform coverage, reimbursement, and utilization management decisions. CMS is implementing its first attempt at lifecycle value assessment through the Inflation Reduction Act (IRA). These developments underscore the critical need for preparation and response to optimally demonstrate treatment value.
- HEOR as a Differentiator Versus a Commodity: Evidence teams are increasingly faced with limited HEOR resources and therefore may focus on doing just the amount of work to “check the box” with payers. Doing so, however, may lead to challenges with differentiating a product’s value with payers as value assessors, such as CMS or ICER. It is increasingly critical to develop strategic, multi-year evidence-generation plans that are designed to meet the needs of payers and providers, while also informing market access strategy and preparing for impacts from the policy environment, such as IRA drug price negotiation.
- Policy’s Pressure on HEOR: More than ever, manufacturers are facing shifting evidence needs across the product lifecycle due to policy developments, with the IRA at the forefront. Manufacturers can supplement current evidence planning with IRA-specific HEOR strategy and may consider adapting pipeline evidence generation planning to incorporate IRA-related requirements.
- Quantifying Indirect Burden and Measuring Novel Elements of Value: Quantitative estimates of disease burden have historically relied on traditional “hard” endpoints such as clinical, cost, and utilization data, while traditional value assessments often use limited cost-effectiveness analyses from the payer perspective. Now, the industry is shifting toward a patient-centric model, making it imperative to better understand the indirect burden of disease to patients, caregivers, and society and to define the novel elements of value that complement traditional metrics.
In fall 2023, Avalere will release a series of videos spotlighting analyses of each of its top 10 trends in HEOR, exploring their interconnections, their anticipated impact on HEOR and other healthcare spaces, and the key implications for stakeholders to consider for their 2024 strategic plans.
This series begins with a vibrant discussion between Avalere experts on the first four trends.
Look for future releases to stay on top of this evolving landscape and learn more about the additional HEOR topics that made this list.
To discuss how Avalere can support your HEOR initiatives or to receive regular Avalere updates, connect with us.
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