Monday, February 1, 2010

Health Economics and Outcomes Research: Too little too late?

So I went to this meeting in Washington, DC, last week, to be a part of the conversation on the value of HEOR in the industry. It was a great meeting, with about 50 attendees, most of whom are intimately involved in HEOR in their every-day lives. It was also somewhat spooky. None of the presenters had shared thoughts prior to the meeting. Yet everyone's message was oddly aligned: we need more quality HEOR studies earlier in technology development.

There was broad consensus that most companies do not have a good understanding of the role, methodologies, or value of HEOR within their development programs. And while clinical trialists are a well accepted asset to the industry, HEOR groups still tend to be the red-headed step children. They have little buy-in from other departments and minimal support from the leadership, and their output is viewed with suspicion. To be sure, there are companies who understand the role of HEOR, and these are the success stories. But majority are still in the dark.

This situation must change, and here are some of the compelling reasons why. While 20 years ago all of the emphasis in drug development was on the FDA approval, today, in our economically constrained healthcare system, no approved technology can succeed without understanding what value it brings to the table over what is already available on the market. No longer can marketers employ smoke and mirrors to develop the "winning" proposition. I would argue that, in general, the industry cannot afford to lag in its understanding of economic arguments behind the payor community.

I have always argued that manufacturers need to be the biggest experts on the diseases they are pursuing and their treatments. This by necessity must include the value proposition of their technologies beyond the statistically significant improvements over placebo required by the FDA for approval. We must develop objective milestones by which to judge worthiness of technologies in development at every point in the development process. Those who do, will adapt to and succeed in this atmosphere of cost controls. Those who do not do so at their own peril. As scientists, citizens, consumers and investors, we should make sure that manufacturers are engaging in this ongoing evaluation of their wares with a critical eye to what value they intend to bring to the society.

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