New Opportunities in Health Economics and Outcomes Research

Several schools of pharmacy are offering fellowships, certificates, or training in pharmacoeconomics or health economics and outcomes research.

The field of health economics and outcomes research (HEOR) is gaining more traction as the health-care system moves to a more value-based care structure. The move means that new educational opportunities are opening for pharmacists.

Virginia Commonwealth University (VCU) School of Pharmacy in Richmond, VA, is the latest school to offer a fellowship in pharmacoeconomics and health outcomes research (PEOR).

The school has partnered with Indivior, a specialty pharmaceutical company, to offer a two-year post-doctoral fellowship. The fellowship is designed to give the recipient experience in both an academic and pharmaceutical industry setting.

“It’s getting more and more important for the pharmaceutical industry--or actually for anybody in health care--to justify the value of whatever services or products they provide, and so there’s a need for people who are trained in the methods of doing that,” said Norman V. Carroll, PhD, Professor of Pharmacoeconomics and Health Outcomes for the School of Pharmacy at VCU.

The fellow will spend much of the first year at VCU and most of the second year at Indivior, Carroll said, with substantial integration with both partners throughout the program.

“At Indivior, fellows will learn more about applying PEOR principles to the development of pharmaceutical products. They will participate in company PEOR research projects like cost effectiveness, cost-benefit, and patient-reported outcomes studies,” said Susan Learned, MD, PharmD, PhD, Senior Vice President of Global Clinical Development at Indivior.

The goal of the program is to prepare the fellow to be able to do pharmacoeconomics and outcomes research in government, industry or academia.

Learned said that for students to be successful in conducting health technology assessments, they will need to have strong PEOR methodological rigor, as well as a practical and in-depth understanding of pharmaceutical drug development, delivery, and reimbursement processes.

“This partnership between industry and academia allows Indivior to support VCU in achieving our common goal of advancing health outcomes research to ensure patient access to quality and cost-effective therapies,” she said.

Health economics and outcomes research is the assessing or evaluating the value of a given drug or intervention on the health-care system.

“Whenever you are looking at adoption of a new intervention, be it a drug or a surgery or any other thing you can think of in health care or even beyond health care, you want to look at two sides: basically the additional cost and the additional benefit of that treatment,” said Richard Wilke, PhD, Chief Science Officer for the International Society of Pharmacoeconomics and Outcomes Research (ISPOR).

The cost can include things like the drug’s list price, but it can also include the amount of physician care or length of a hospital stay involved in an intervention or treatment. On the benefits side, researchers assess what improvements are likely to occur in the average patient under a given treatment relative to standard care.

“You compare the additional benefits to the additional costs and you see how much the additional benefit is going to cost my health-care system or my pocket book,” Wilke said.

Although the industry got its start about 20 years ago-ISPOR was started in 1995-HEOR is becoming even more important in the era of value-based care.

“As our health-care spending grows faster than our GDP, it gets more and more attention and we are making more and more trade-offs to pay for health care. So the importance of knowing what the right trade-offs to make and what health care to pay for relies on really understanding the value of care,” Wilke said.
ISPOR has more than 20,000 members with nearly 100 chapters across the world. “We have really seen an exponential growth,” Wilke said.

As the need for HEOR grows, so does the number of educational opportunities. VCU isn’t the only school to offer a fellowship in the area of HEOR. A search directory from the American College of Clinical Pharmacy lists multiple pharmacy fellowships that have a primary focus in outcomes research.

Schools also offer doctoral programs, master degrees, or certificate programs in HEOR.

In addition to a doctoral program, the University of Washington in Seattle offers three different fellowship slots in HEOR, two in conjunction with Allergan and one in conjunction with Bayer.

“Those students come to us with PharmDs, but also with past experience in HEOR through research projects and course work they’ve taken as PharmDs,” said Beth Devine, PhD, PharmD, MBA, the Director of Graduate Programs for the Pharmaceutical Outcomes Research and Policy Program and Associate Professor at UW’s School of Pharmacy.

This year’s fellows also already have master’s degrees. “They’ve really already demonstrated an interest in HEOR,” Devine said.

Similar to the program at VCU, fellows at UW spend their second year of the fellowship primarily working at the program’s pharmaceutical company partners.

“They often are offered opportunities to work on a variety of projects using their different skills sets that they developed in the first year,” Devine said. “At the end, usually they are quite well-trained and then can secure a well-paid position in the pharmaceutical industry.”

During the second year, students are able to combine their quantitative skills with the strategy they’ve learned during the program. “Those can be pretty rewarding positions. They are very exciting,” Devine said. “You are talking about strategy for launching medications or market access for different markets in the U.S. or globally.”
There are also education options for pharmacists who don’t want to commit to the full-length of a fellowship. The School of Pharmacy at UW also offers a certificate in HEOR. The distance learning certificate is earned after participants’ complete one course each quarter, for a total of three quarters.

“Students who enroll get an exposure to health economics, decision modeling, and health technology assessment in different countries globally,” Devine said.

The school has about 60 to 75 people who go through the certificate program yearly.

“Completion of the certificate program is a really a nice way to kind of put your toe in the water without a commitment to the long term,” Devine said.

ISPOR also offers continuing education opportunities and training courses.

The organization hosts three conferences a year, which typically include 60 different short courses on a variety of HEOR issues.