Health Economics and Outcomes Research (HEOR)

Introduction

Health economics and outcomes research (HEOR) is a data-driven methodology that is used to inform decision-making in healthcare and clinical research. It is used extensively by governing bodies, institutions, and private companies to develop an analytical approach to healthcare decision-making, with the end goal of improving healthcare for patients, healthcare professionals, and researchers alike.

In this article, we will define HEOR and discuss its importance and how it is used to improve decision-making in clinical research.

What is health economics and outcomes research (HEOR)?

At its core, health economics and outcomes research (HEOR) refers to analyzing the value of various healthcare interventions by comparing a host of metrics and market indicators. This information helps healthcare-related organizations make strategic decisions about their research directions, treatments, and patient care.

HEOR is effective because it generates meaningful and practical information for healthcare decision-makers, by combining two vital components: health economics and outcomes research.

Health economics involves the analysis of economic factors and trends influencing the healthcare industry and the decision-making processes of different actors in relation to healthcare, including patients, researchers, and government bodies. Entities of both the public and private sectors use these analyses and forecasts to develop strategies for making healthcare more affordable and accessible.[1]
Outcomes research refers to the assessment of the outcomes (results) of medical treatments and interventions using real-world evidence (RWE). Decision-makers in healthcare, clinical research, and drug development organizations can make use of this research data to inform and develop future strategies.[2]

HEOR has been around since the 1960s. However, it wasn’t until 1995 that the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) pushed for its progression and it started to become more widely adopted.

By laying a foundation of competencies for professionals in HEOR, the ISPOR outlined the training and skills required to develop and interpret healthcare economic evaluations, opening the door for integration of HEOR considerations and specialists into many more organizations.[3]

Top trends in health: Why is outcomes research important in healthcare?

Outcomes research is important in healthcare because real-world evidence (RWE) offers practical and valuable insights into the success of healthcare interventions, which can be used to inform decisions that determine the future directions of healthcare and health research.

HEOR provides data that can lead to the creation of novel solutions addressing the real needs of patients to improve their quality of life. The following trends in health (as identified by and/or proven by HEOR) have been shown to improve patient outcomes:

Using real-world evidence (RWE) to accurately assess the performance of both existing and new drugs and treatment plans.

Using real-world evidence as a complement to randomized controlled trials (RCTs) to provide additional evidence to inform healthcare decision-making.
Using cost-effectiveness analysis (CEA) to evaluate medical treatments in conjunction with risk assessment, equity valuation, and illness severity.
Using real-world evidence and long-term outcomes analysis to determine the cost-benefit ratio of funding innovative technologies.
Using HEOR data to increase patient engagement and the dialogue between patients and researchers. Patient engagement models suggested and backed by HEOR include conference sessions, publications, training, and posters.

How clinical research study outcomes influence healthcare

Clinical trials produce robust data on individual treatments/drugs, under controlled conditions and under rigorous scientific standards.[3] By studying aggregated clinical research study outcomes, policymakers within the healthcare system can determine the optimal/recommended treatment(s) for conditions, design policies that improve public health, and suggest new avenues for advancing treatments and patient care.

Clinical research studies, particularly Phase IV clinical trials (post-marketing surveillance studies) that focus on gathering real-world evidence of the long-term side effects of drugs and treatment performance, are important sources of the real-world evidence and data employed and analyzed in HEOR. The health outcomes revealed through clinical trials make up part of the database used by HEOR models to influence healthcare strategies.

How HEOR data can improve clinical research

While clinical trial data and outcomes are a primary source of data feeding the analytical models used in HEOR, HEOR data can also be used to improve clinical research.

Through HEOR approaches, clinical trial sponsors, sites, and researchers can use real-world data to simulate the effectiveness, costs, and forecasted outcomes of potential medical interventions before bearing the burden of an actual clinical trial. In other words, HEOR data can direct and guide drug development efforts, and can be valuable for feasibility studies or other preclinical developments.

Other ways that HEOR data can be used in (or to improve) clinical research include[4]:

Gathering patient data through surveys
Identifying niche markets to develop drugs and treatments based on specific patient needs
Analyzing and comparing existing drug and treatment options to advance research in novel interventions to improve patient outcomes
Identifying patient populations that can benefit the most from novel treatments and increasing their enrollment and retention in clinical research studies
Elaborating feasibility studies to determine the economic practicality of conducting a clinical trial for new drugs or new uses of existing drugs
Assessing a drug’s long-term effectiveness and economic implications, alongside health outcomes, through Phase IV trials

Conclusions

HEOR has a two-way synergistic relationship with clinical research, with clinical trial data being used in HEOR models and HEOR data being used to refine and improve clinical research. HEOR is increasingly seen as an integral undertaking in healthcare, pharmaceutical, and government organizations due to its ability to inform decision-making and policy. As real-world evidence is increasingly used to inform the direction of healthcare and research, the hope is that patient care can be improved while simultaneously making healthcare more cost-effective and affordable.