Health Economics and Outcomes Research (HEOR)

Health Economics and Outcomes Research (HEOR)

Led by Director and Principal Andrew Briggs, DPhil, and CEO John Schneider, PhD, AHE researchers and consultants have extensive knowledge and experience in the field of health economics and outcomes research (HEOR). These services include a wide variety of offerings across the product development continuum. In the early stages of development, we provide insights and analysis on potential market size and the design of rigorous economic evaluations, such as clinical studies and cost-effectiveness analysis. In later stages of development, we can offer more in-depth analyses to support expanded market access. For more information, view one of our past presentations on Establishing the Value of New Drugs, Devices, and Diagnostics.

We have extensive experience in advising health care leaders and managers in the following HEOR areas:

  • Evidence Planning & Study Design
  • Conceptual Models
  • Literature Synthesis & Meta-Analysis
  • Data Sourcing, Analysis & Interpretation
  • Economic Modeling, Cost Effectiveness Analysis & Budget Impact Analysis
  • Web-Based Graphical Model User Interfaces
  • Patient-Reported Outcomes & Utilities
  • Market Access & Reimbursement
  • Payer Research and Engagement
  • Peer-Reviewed Publications & Communications
  • Medical device total cost of ownership (TCO) analysis
  • Real-world data analysis using large datasets, including Truven, Pharmetrics, Medicare claims data, etc.
  • Support to Value Analysis Teams (VAT) & Value Analysis Committees (VACs) for hospitals & health systems
  • Hospital Value Analysis (HVA) of medical devices
  • Clinical research monitoring and study coordination

Sample Projects

Economic evaluation of disposable IV catheter.
This project built an economic model of an IV catheter to calculate the cost impact based on the role of the catheter in reducing needle stick injuries and reducing blood splatter and leakage. Four leading brands were compared in a hospital value analysis. The model was created in Excel and featured a user-friendly interface for support client sales and communication efforts.

A U.S. Hospital-Perspective Economic Evaluation of Procalcitonin-Guided Antibiotic Therapy in Acute Respiratory Infections.
This project is part of our unique capability in the economics of diagnostics. PCT has the potential to improve the management of acute-care resources by: (1) reducing unnecessary antibiotic prescriptions (i.e., supporting improved antibiotic stewardship); (2) reducing hospital lengths of stay; (3) improving the timing of diagnosis and treatment; and (4) improving the ability of clinicians to optimally match diagnosis and treatment. All three of these impact pathways have implications for health outcomes, which in turn have the potential to generate additional secondary economic effects. We conducted a study of the costs, economics, and “value proposition” for the use of PCT to manage infections in U.S. acute care hospital-based settings. The project was then extended to Chile, China, and the UK.

Economic evaluation of a Lyme disease diagnostic.
We conducted an economic evaluation of novel Lyme assays (NLA) measuring IgG and IgM antibodies separately relative to current standard Lyme assays (SLAs) to test for economic advantages associated with NLAs. We built a clinical laboratory financial model for NLA versus SLA and estimated laboratory financial results for a hypothetical catchment area with a population of 1,000,000. Using NLAs, Western blot (WB) usage is reduced. For the cohort of 1 million, expected costs to the laboratory increase slightly when using NLA versus SLA. Expected revenue associated with the increase in first-tier testing increases laboratory revenue from Lyme testing. The increase in revenue results in increased laboratory margins on Lyme testing.

Economic evaluation of an implantable heart failure device.
We conducted a rigorous cost-effective analysis (CEA). The CEA will also be used to support a budget impact model (BIM) for a hypothetical U.S. payer. A partial review of the literature was conducted on the following HF-related topics: epidemiology, treatment, cost-effectiveness of treatment, health-related quality of life (HRQoL), disease progression (including disease stages), risk adjustment, and risk prediction. These analyses were used to evaluate each of the components of the study protocol and make recommendations to include collection of health economics data, including measures addressing the following elements: (1) resource use; (2) outcomes (including survival and risk prediction); and (3) HRQoL and health-state utilities. The key economic measures added include costs of: BNS system, implantation procedure, follow-up, medications, implant replacement, hospitalizations, other cardiovascular implantable devices, physician visits, emergency department visits, optimal medical treatment (OMT) patients following withdrawal, and post-acute care.

Budget Impact of an Allergic Rhinitis Treatment
Allergic rhinitis (AR) affects 10-20% of the US population, with treatment costs exceeding $6 billion annually. US practice guidelines suggest treatment with a combination of intranasal corticosteroids and antihistamines. MP29-02 is intranasal formulation of azelastine hydrochloride and fluticasone propionate in an advanced delivery system indicated for the relief of symptoms of seasonal AR (SAR). Patients treated with MP29-02 experience significantly greater symptom relief in comparison to first-line therapy in trials. This project used an economic model to calculate the per-member per-month (PMPM) budget impact on a US health insurer of moving MP29-02 from third-tier to second-tier pricing and reimbursement. Read more about Improving Adherence to Seasonal Allergic Rhinitis.

The economics of cancer biomarkers
This project is part of our unique capability in the economics of diagnostics. This project created a conceptual framework and reviewed the current literature on the economics of cancer care biomarkers and pharmacogenomics. Biomarker use for screening, monitoring, diagnosis and treatment optimization has the potential to improve patient outcomes and reduce costs associated with inappropriate (or suboptimal) therapeutic regimens. Read more about the Economics of Cancer Biomarkers, or read our news article about CEO John Schneider speaking at the 6th Annual Latin American and Canadian Clinical Laboratory Symposium.

Cost effectiveness of a novel biomarker combination in ovarian cancer treatment
This project is part of our unique capability in the economics of diagnostics. This project examined the cost effectiveness of the Risk of Ovarian Malignancy Algorithm (“ROMA”—a combination of CA125 and HE4) relative to CA125 alone for identifying ovarian tumor malignancy. We used cost effectiveness modeling to explore the hypothesis that ROMA results in improved triage of patients to specialized centers, where they are more likely to receive optimal treatment. Read our news article about CEO John Schneider speaking at the 6th Annual Latin American and Canadian Clinical Laboratory Symposium, or our blog on The Economics of Ovarian Cancer Diagnostics.

The economics of clinical practice guidelines
Clinical practice guidelines (CPGs) in many cases specify a target level of process quality or target mix of inputs, neither of which may explicitly take into consideration the relative costs of treatment and economic efficiency. The effects of CPGs are likely to extend beyond clinical dimensions. CPGs are a form of process innovation, resulting in changes in care processes, human resources, the use of information, and other organizational components. This paper reviews the theory and evidence on the dual clinical-organizational effects of guidelines. The goal is to put forth a framework for future studies of the cost impact of CPGs. Read more about Clinical Practice Guidelines and Organizational Adaptation.

Cost effectiveness of a point-of-care test for adenoviral conjunctivitis
This project is part of our unique capability in the economics of diagnostics. Clinical differentiation between adenoviral and bacterial conjunctivitis is difficult, often resulting in misdiagnosis and the provision of inappropriate treatment. A cost-effectiveness analysis was performed from a societal perspective using primary, secondary, published literature, and expert opinion data sources. The incremental costs and effects (cases of unnecessary antibiotic treatment avoided) for a rapid point-of-care test for adenoviral conjunctivitis were modeled. Budget impact models were developed to determine the impact on commercial payers. Read more about the Cost-Effiectiveness of a Point-of-Care Test for Adenoviral Conjunctivitis.

Effects of health savings accounts (HSAs) on health care and medical care utilization
The objective of this project was to assess the impact of a HSA-eligible health plan on utilization and expenditures in an employer-sponsored Midwestern health plan which offered a traditional plan from 2003 through 2004 that was fully replaced by an HSA-eligible plan in 2005 and 2006. The design of the study was a retrospective pre-post design with a control group. Read more about the Effects of Health Savings Accounts on Health Care and Medical Care Utilization.

Cost-effectiveness of a public awareness campaign for a government payer service offering
We collaborated with a large national public relations firm to provide an economic evaluation component of a larger program-level evaluation of the public awareness of some subcomponents of a government health care program. We conducted data analysis, cost-effectiveness analysis, cost-benefit analysis, policy analysis, and program evaluation.

Assessing patient-reported outcomes using advanced social media sentiment research
A life sciences company is seeking novel ways of assessing disease and therapeutic data from internet-based sources, including social media, blogs, and comment/discussion compilations. Advanced internet scanning software was used. Digital internet content can provide an additional window into how patients perceive their illnesses, including humanistic and economic burden.

Claims analysis of ambulatory surgery reimbursement rates
We analyzed a large database of commercial health insurance claims over a five-year period to determine average charge and payment rates for ambulatory surgery procedures nationally. Medical care charges and billing data were compared to prevailing rates (usual, customary, and reasonable, or UCR) in addition to alternative means of calculating reasonable value.