As healthcare systems face growing pressure to allocate limited resources, payers are demanding clear evidence that treatments deliver measurable value.
For pharmaceutical manufacturers, Health Economics and Outcomes Research (HEOR) provides critical, data-backed insights into how treatments drive value in the real world. This research is instrumental in shaping stronger market access cases, enabling evidence-based payer negotiations, and accelerating adoption.
In this article, we explain the fundamentals of HEOR research, break down some representative methodologies, and explore why HEOR is an increasingly indispensable pillar for pharmaceutical market access strategies.
HEOR is a discipline within life sciences organizations that develops structured evidence to demonstrate the value of medical interventions. For pharmaceutical companies, HEOR plays a critical role in connecting treatments to real-world outcomes, offering payers and other stakeholders a clearer view of how therapies perform beyond the clinical trial setting.
In an article advocating for more integrated approaches to evidence generation in biopharma, McKinsey notes a few key trends fueling an increasingly central place for HEOR research:
HEOR research supports a wide range of use cases that directly shape pharmaceutical commercialization campaigns:
Unlike traditional efficacy data, HEOR takes a broader perspective on value. It considers not only clinical effectiveness but also economic impact and patient-reported outcomes. To do so, it draws on sources like health records, patient surveys, and observational studies.
At a high level, HEOR analyzes two fundamental aspects of a given therapy’s economics:
As we explore below, a variety of different methodologies can contribute to this foundational understanding.
HEOR encompasses a wide range of analytic tools and study designs; the following methodologies form the foundation of typical value assessments.
While clinical trials provide controlled efficacy data, real-world evidence (RWE) captures how therapies actually perform across diverse populations and practice settings. RWE draws on sources like electronic health records and patient registries to provide a more complete view of efficacy in practice.
RWE can also highlight access gaps and help identify patient populations that benefit most from a therapy. For pharmaceutical companies, this can translate directly to stronger arguments for formulary placement, better-informed payer segmentation strategies, and more adaptive lifecycle planning.
Cost-effectiveness analysis (CEA) compares the economic and health outcomes of two or more interventions to determine which offers the best value. CEA does not seek to simply identify the lowest-cost option but to understand which therapies deliver the most benefit per dollar spent.
HEOR teams may use different types of economic evaluations depending on the context. For treatments with largely equivalent outcomes, cost-minimization analysis may be sufficient for selecting the most efficient treatment option. For therapies with more nuanced differentiation, however, a deeper cost-effectiveness analysis may be needed to weigh costs against concrete benefits measured by life-years gained and quality-of-life metrics (see below).
HEOR incorporates quality-of-life (QoL) assessments to measure how patients experience their treatment. These evaluations often rely on standardized patient-reported outcomes (PROs), which provide structured insight into physical, emotional, and functional well-being.
Quantifying how a therapy affects daily life (from managing side effects to enabling routine activities) is crucial to complete an access narrative. These insights can be especially critical in competitive categories, where incremental improvements in patient experience may distinguish one therapy from another.
While HEOR offers tremendous strategic value, pharmaceutical teams often face practical challenges when trying to apply this data across the product lifecycle.
As the challenges outlined above suggest, tapping into the value of HEOR for pharmaceutical commercialization requires more than just relaying the relevant data to payers and HCPs. Outcomes research carries the most weight when it is developed with purpose and communicated with precision.
At TJP, we work with clients to ensure that outcome metrics align directly with concrete decision points (like formulary review, contracting discussions, and patient access policy development). From there, we shape our presentation of those metrics to speak to the specific criteria employed by the relevant stakeholders.
This approach is rooted in a deep understanding of how payers frame value. While clinical effectiveness and cost remain essential, the most persuasive evidence often speaks to operational impact: time to treatment, resource utilization, quality-of-life improvement, adherence support, and system-level cost offsets. We help clients identify the specific measures and outcomes that will resonate with each payer segment, then use that understanding to inform both the research approach and the communication strategy around it.
Long-term, the result is not just a static deliverable but a foundation that supports ongoing engagement. We help translate research findings into payer-facing narratives, field team resources, and tools that support real-time interactions. In our experience, this is the best way to truly embed HEOR into the broader commercialization plan.
TJP’s work supporting a novel therapy for Duchenne Muscular Dystrophy (DMD) provides a detailed example of how HEOR fits into a successful market access strategy. In this case, despite leading Medicaid coverage within its category, the therapy faced persistent barriers to prescribing due to complex payer requirements and administrative friction.
To address the challenge, we supported the manufacturer in conducting both direct and indirect cost analyses tied to treatment outcomes. Once cost offsets for payers were identified, TJP helped build an outcomes-driven value story to support strategic payer engagement.
Next, TJP partnered with the manufacturer to identify the root causes of treatment delays and streamline the access process. Through targeted advisory boards, we surfaced specific pain points in prior authorization and documentation workflows, which were contributing to significant lags in therapy initiation. In response, we developed a suite of tailored tools, including a Letter of Medical Necessity (LMN) builder and standardized patient status forms, to support providers with faster, more complete submissions.
The impact was clear. The average delay in therapy start time dropped by 27 days. Provider feedback emphasized ease of use and reduced administrative burden, and the LMN builder quickly became the most-visited resource on the product’s website.
TJP builds HEOR into the core of market access planning, linking evidence generation directly to payer strategy, patient access, provider engagement, and launch execution. Our work helps teams translate clinical and economic data into powerful narratives and actionable tools.
We collaborate with pharmaceutical teams to ensure HEOR insights are not only rigorous but also strategically deployed, ready to support everything from pricing to field training. Evidence generation that is carefully aligned with real-world decision points is the key for brands to improve access outcomes.
How can we help leverage data-driven insights to strengthen your market access strategy? Reach out to our team to discuss.