Understanding health economics and outcomes research (HEOR) from a non-health economist lens!

Remember the dilemma of Alan Turing from the movie The Imitation Game where to optimize for a war winning strategy he happened to decide on the fate of American soldiers.
Sometimes people have to play God as we have to accept the harsh truth of life that “everybody cannot be saved”, unless human species advances to the level of octopus-like-aliens from the movie Arrival!

Consider a similar scenario where the war ground is replaced by a hypothetical island hit by a pandemic and soldiers dying are replaced by patients affected by the pandemic and Guliver is the fortunate (or the unfortunate) health economist who has to decide on allocation of limited healthcare budget.

Also, let’s assume that historically the government has been spending all of the budget on curing insomnia which happened to be the only disease among people there. The mortality rate accrued to insomnia under no medication was estimated to be 2% which under medication reduces to 0% . For the pandemic the mortality rate is 5%. The government is ready to fund research for the treatment though there is no certainty of success even if they pool all the funds into research for pandemic cure.

So, there is an economics to health as governments have a limited budget to spend on healthcare services and it’s crucial to optimize this budget over various healthcare facilities and technologies.

Luckily, the island has good data practices which can help Guliver (the health economist) to design a mathematical problem with an objective function and budget constraints.

There are core assumptions in this simplified version which can be dropped going further. A few of them as follows:

Different individuals can have different chances of survival
All lives are equally important for the government.
Quality of life after treatment is assumed to be same for everyone
Individuals with the same level of health are assumed to be equally happy, hence maximising aggregate social welfare measured in terms of aggregate individual utility will give the same results.

So the problem narrows down to estimating survival probability for individuals which can depend on various factors such as –

Patient-specific factors- age, gender, medical history, sanitation, heredity, social exposure
Awareness-specific factors – social distancing measures, expenditure on awareness
Political and social factors – poverty, unemployment rates
Disease and treatment specific factors – Nature of the disease (or severity levels), available treatments, adverse effects
Other factors – qualification/ capability of researchers in the country, time given for research, ability to produce new research

Once the functional relationship between the individual survival probabilities and various affecting factors is determined (which can be done using traditional or advanced mathematical and statistical approaches), Guliver can weigh up the benefits and costs of healthcare services to decide whether they are good value for money (or within the threshold of budget) in the pandemic time. These analyses will help in decision-making, which allows the government to provide the best healthcare to people in the island.

This is a major component of a Health Economics and Outcomes Research (HEOR) research or job. The market for HEOR was 0.7 billion in the year 2019, and is predicted to continue to grow in the coming decade. The market size will rise even during or after the current COVID-19 pandemic time, as it is currently most essential than ever to conduct value-based analysis and evidence based research.

There will be a growing need for HEOR in emerging economies as the health technology assessment (HTA) systems sprout or develop in these countries. Regarding the future of HEOR- The emerging use of machine learning, real world evidence data, digital healthcare, and precision medicine is initiating a new wave of research into HEOR.

Let’s prioritize evidence-based research for safe, affordable and efficient healthcare delivery!

About connectHEOR:
ConnectHEOR is a specialized consultancy in HEOR and RWE services. To learn more about us: please visit Connectheor.com or email at [email protected]

Model Conceptualization and Data Analytics

Senior Consultant

PhD – Health Economics

Thai-Son Tong

PhD. Health Economics

Thaison Tong has extensive work experience in health economics, decision modelling and big data analysis. He has a unique mix of experience in HEOR and RWE related research in academia and pharmaceutical industry. His expertise lies in health technology assessments (HTA), health economic modelling, simulation modelling, big data analytics and decision analysis. He has hands-on experience in a range of software and programming languages including R, R Shiny, R Markdown, Python, MS Excel, VBA, and Simul8. He has substantial experience of the health care system in the UK and other European countries. 

Thaison has direct experience in building cost-effectiveness models from scratch and conducting big data analysis in several disease areas including dementia, vascular disease, and cancer. 

Thaison’s PhD focus was to develop a de novo patient level model for the evaluation of different cognitive screening tests for early detection of dementia and mild cognitive impairment in primary care. He also looked at different methods for conducting economic evaluation in health care taking a broader/societal perspective. In addition, he investigated the use of Multiple Criteria Decision Analysis (MCDA) for economic evaluation.

Thaison also holds Academic Researcher position in School of Health and Related Research (ScHARR), University of Sheffield, UK and Honorary Researcher position in University of Bristol, UK.

Thaison’s likes to meditate, and play badminton, basketball and tennis.

Consulting and strategy

Vice President

MSc. International Economics

Shilpi Swami

MSc. International Economics

Shilpi Swami is a seasoned Health Economics and Outcomes Research (HEOR) expert with experience spanning across multiple healthcare systems and therapy areas. At her current role of Vice President, HTA and Strategy, ConnectHEOR, she provides technical and strategic leadership. Additionally, Shilpi serves as the Member Engagement Co-Chair at ISPOR Oncology Special Interest Group.

Shilpi has a comprehensive track record of leading HTA submissions and devising market access strategies on a global scale, including the EU-5, Canada, US, Latin America, Australia, and Asia. Shilpi has worked across various sectors within health economics, including academia, consulting, and biopharma. This multidimensional experience equips her with a unique ability to offer strategic insights from various stakeholders’ perspectives.

Formerly a Research Fellow at the University of York, Shilpi has made significant contributions to public health projects and the development of best practices in the academic side of health economics. In her professional endeavours, she remains dedicated to improving healthcare through data-driven insights and evidence-based research.

Health Technology Assessment

Scientific HTA Advisor

Ph.D, MBA, Stockholm School of Economics

Prof. Egon Jonsson

PhD Economics

Professor Jonsson has more than 25 years of experience as a leader and researcher at national and international organizations on Health Technology Assessment (HTA) including Health Economics. He is very knowledgeable of the regulatory requirements of pharmaceuticals, medical devices and other health technologies and services, in many of the European countries, Canada, and US, as well as of several Asian countries. He has performed many syntheses of scientific findings through systematic reviews, cost-effectiveness, cost-benefit, and budget impact analyses, modelling studies, meta-analyses, RWE and HEOR studies. He is known for his ability to engage with decision makers in agencies and at the ministerial levels, and with clinicians in primary health services and hospital care as well as with patient organizations and the general public. He is good at presenting scientific findings along with their economic, medical, social and quality of life implications in such a way that it supports the uptake of effective technologies and services provided by the life sciences industry.  He has a huge international network of researchers, HTA experts, clinicians and decision makers in Governments, Academia and Industry.

Professor Jonsson received his Ph.D. and MBA from the Stockholm School of Economics in Sweden and further training at Harvard School of Public Health in the U.S. He was one of the founders of HTAi, its Society, and scientific Journal of which he was a long time Co-Editor -The International Journal of Technology Assessment in Health Care. He successfully has taken on several major roles as manager and leader of organizations in evidence-based health care; such as being the CEO of the Swedish Agency for Health Technology Assessment (SBU.se), the Leader of the WHO Health Evidence Network (WHO. Int.Hen), and as the CEO of the Institute of Health Economics in Edmonton, Canada (IHE.ca). He has done several hundreds of HTAs. His publications include more than 90 peer reviewed manuscripts, and as Editor of about 20 books on a variety of diseases and disorders. He has served as a long-time advisor to Ministers and Ministries of Health in Sweden, Vietnam and of the Government of Alberta.

Professor Jonsson has been a consultant in HTA in many countries of Europe, Asia and the former Republics of the Soviet Union, on behalf of the European Commission, WHO, the World Bank, and the Swedish Medical University Karolinska Institute.

Besides, Professor Jonsson has award on his name – ‘The Egon Jonsson Award’. This award was established in 2010, and is given annually by HTAi to the authors of an outstanding paper in the society’s official journal published over the past year.

Big Data Analytics

Senior Consultant

MSc. Quantitative Economics

Kunal Hriday

MSc. Quantitative Economics

Kunal Hriday is a business strategy and data science professional with experience in helping organizations crack through notorious business challenges. Kunal is proficient in business analytics, data analytics, database management and business development. Working as a Data analytics consultant he has spent time in problem solving across variety of industries including Banking, logistics and Health and is now fully dedicated to HEOR related analytics. Kunal has hands on experience in various statistical programming tools and languages like R, Python, SAS, Excel VBA, Data Robot and data visualization tools like Power BI, Tableau and SAS VA.

Kunal also holds a Masters in Quantitative Economics from Indian Statistical Institute and a bachelors degree in Business Economics. Excellent in business communication, he is passionate about studying economics and welfare optimization theories.

Review and Scientific Communication

Principal Consultant

PhD (Pharmacy)

Raju Gautam

PhD. Pharmacy

Raju Gautam has extensive work experience in evidence review and synthesis, value communications, scientific publications, medical writing and project management.
His expertise lies in systematic and targeted literature reviews, meta-analyses, network meta-analyses, value communications (AMCP and Global Value Dossiers), RWE study design and publications (manuscripts, posters, and abstracts).
He has experience working in Global pharma companies, consulting and CRO environment for several therapy areas including Cardiovascular, Oncology, Neurology, Respiratory, Ophthalmic, Rare Diseases, and Vaccines. He has more than 40 publications in international journals as an author.
Raju also likes jogging, yoga and meditation.

Scientific Writing, Literature Reviews, Evidence Synthesis, Meta-analysis, Real World Evidence

Senior Consultant (Director) – (Review and Patient-Centric Research)

MBBS (Bachelor of Medicine and Bachelor of Surgery), PhD (Global Public Health) – University of York

Radha Sharma

MBBS, PhD (Global Public Health)

Radha Sharma is an evidence synthesis scientist with a background in medicine, public health and epidemiology. Her expertise includes global health research, epidemiological analysis of big data sets, RWE study design, literature reviews, meta-analysis, scientific writing, and qualitative health research.

With a unique combination of clinical and academic skills, Radha facilitates Health Technology Assessment (HTA) reimbursement submissions and value dossiers by conducting systematic reviews, writing and reviewing clinical sections, and effectively communicating scientific findings.

Her experience in conducting statistical and econometrics analyses, along with her in-depth knowledge of global health research and qualitative health research, ensures that the results of her systematic reviews and meta-analyses are robust and accurate.
Radha is an avid hiker and enjoys exploring the beautiful Canadian Rockies.

She also often spends her time painting on large canvases with acrylics.

Statistical Analysis and Evidence Synthesis

Director of Statistics

Ph.D Probability and Statistics

Kate Ren

PhD Probability and Statistics

Dr. Ren is our senior statistical expert and spearheads department of Statistics at ConnectHEOR. She has more than 10 years of experience in conducting statistical analysis in HTA. Kate is also a Senior Research Fellow at School of Health and Related Research (ScHARR), University of Sheffield. Kate has PhD in Probability and Statistics specialising in Bayesian methods in clinical trial design. She specializes in Bayesian methods in health economics and the elicitation of experts’ beliefs and has extensive experience of conducting evidence synthesis, including, meta-analysis, network meta-analysis, MAIC, etc.

Kate has extensive experience for critiquing network meta-analysis methods in single technology appraisals (STAs) and undertaking network meta-analyses for multi technology appraisals (MTAs) for NICE.

Decision Modelling and AI Initiatives

Director and Principal Consultant

MSc – Statistics and Computing

Tushar Srivastava

MSc – Statistics and Computing

Endorsed as a ‘Global Talent’ by prestigious ‘The Royal Society, UK’, Tushar is dynamic and  enjoys approaching complex problems with a holistic approach. He also holds an MSc. in Statistics and has authored a handbook on higher Mathematics, “A concise handbook of vector space theory and field theory, Srivastava T.”

Tushar’s technical expertise lies in different techniques including cost-effectiveness modelling, budget impact modelling, simulation modelling, statistical modelling and indirect comparisons analysis. He brings a unique blend of academic research, technical modelling and statistical skills and industry professionalism to support the life science industry at every stage of the product life cycle. He has a good experience in statistical analyses, including survival analysis and health related quality of life data analysis from clinical trials.

Tushar has worked in multiple  disease areas including oncology, CVD, infectious diseases, rare-diseases such as Fabry disease, ulcerative colitis, Crohn’s disease, and multiple sclerosis. He has extensive experience of product launch in countries in Europe, the United States, Latin America, and Australia. He also holds an Academic Researcher position in ScHARR, University of Sheffield, UK.

Besides work, Tushar enjoys playing badminton, jogging, and meditating.