* Program subject to change
Level: Intermediate
Track: Health Policy & Regulatory
The value of medical innovation depends on the perspective. Registration authorities (EMA, FDA) mainly consider the clinical value of the medical innovation, whereas national health authorities take a broader perspective by including clinical, economic criteria, and potential other criteria like equity and social values. Value-based pricing is the most widely accepted approach in the pricing and reimbursement process in Europe, which varies from the narrow concept based on the incremental cost-effectiveness ratio (ICER) threshold to broader approaches. Value-based pricing determines the maximum price from the national payer perspective. This price should exceed the minimum price for the investor acting in the international financial market, which is based on economic valuation theory. Finally, there are other stakeholders, eg, patients, physicians’ healthcare insurers, employers, with their specific assessment of the value of medical innovation varying from, respectively, quality of life, effectiveness, budget impact, and costs of lost productivity. This course offers an overview of the perspectives of the relevant stakeholders and their respective data requirements for value assessment of innovative drugs. The course will then describe in-depth description of the various value-based pricing methods, eg, ICER, multicriteria decision analysis (MCDA), comparative effectiveness research (CER), and relative effectiveness (RE). We include examples of orphan drugs and ATMPs which are most striking to illustrate the concepts, but we also include value assessment for more traditional innovative drugs in broad indications. Familiarity with health economic evaluation is desirable, but the course assumes little or no familiarity with economic valuation theory.
Afschin Gandjour, MD, PhD, MA, MBA
Frankfurt School of Finance & Management, Frankfurt, Germany
Lou Garrison, PhD
University of Washington, Seattle, WA, USA
Marlene Gyldmark, MPhil
Idorsia Pharmaceuticals, Allschwill, Switzerland
Mark Nuijten, MBA, PhD, MD
Ben Gurion University, Be'er Sheva, Israel
Fred W. Sorenson, MSc
Cencora, Basel, Switzerland
Level: Introductory
Track: Methodological & Statistical Research
The rapid advancement in generative artificial intelligence (Gen AI) presents an opportunity for transformative potential in the field of Health Economics and Outcomes Research (HEOR). This course provides an introductory understanding of generative AI models with a particular focus on large language models (LLMs), which are revolutionizing the field of HEOR. Participants will be provided with an overview of the most appropriate ways to access LLMs, going beyond the use of chatbots. Further, they will be given insights into how to use prompt engineering to conduct scientific research and gain an understanding on issues pertaining to privacy and security when using Gen AI for HEOR. Participants will further explore specific applications of these models for conducting robust scientific HEOR research in systematic literature review (SLR), real-world evidence analysis, and economic evaluation. The course aims to equip participants with the knowledge to begin to use generative AI techniques for specific HEOR contexts and to appreciate how these innovative approaches can enhance HEOR activities. Practical exercises using Python and relevant AI frameworks will be incorporated for participants to follow along. Participants who wish to gain hands-on experience are required to bring their laptops with Python installed.
PREREQUISITES: Students should have a general understanding of common HEOR concepts such as SLRs and cost-effectiveness models. Knowledge of Python or similar programming languages such as R is considered a benefit, but not required.
Sven Klijn, MSc
Bristol Myers Squibb, Utrecht, ZH, Netherlands
William Rawlinson, MPhysPhil
Estima Scientific Ltd, London, United Kingdom
Tim Reason, MSc
Estima Scientific Ltd, South Ruislip, LON, United Kingdom
Track: Health Technology Assessment
As the cost of bringing a new health technology to market continues to climb, more and more firms, developers, and investors are searching for tools to prioritize their efforts on the technologies with the greatest potential for clinical impact and market viability. While health economic analysis has long been established as a necessity to inform decision making for market access and reimbursement, it is increasingly being used at earlier stages of product development for healthcare and life sciences to increase the access rate of R&D and efficiently prioritize data collection. The number of available methods for this field has continued to expand.
This course aims to demystify the objectives of early-stage health technology assessment and the methods of translational health economics. Students in the course will gain a thorough understanding of available methods for early-stage technology assessment, the specific challenges and solutions, and a clear sense of how to implement this in the complexity of health technology development, funding, regulation, pricing, and reimbursement. The course will utilize real-world examples and students will have the opportunity to strategize about the creation of a research plan for their purposes.
PREREQUISITE: Familiarity with key elements, methods, language, and basic health technology principles are prerequisites to attending this course.
William Canestaro, PhD, MSc
Washington Research Foundation, Seattle, WA, USA
Erik Landaas, PhD, MPH
W. L. Gore & Associates, Inc., Flagstaff, AZ, USA
Lotte Steuten, MSc, PhD
Office of Health Economics, London, LON, United Kingdom
Level: Experienced
Track: Real World Data & Information Systems
In recent years, real-world evidence (RWE) has been increasingly used to inform regulatory, payer, and health technology assessment (HTA) decisions, as well as clinical guideline development. In addition, it has been recognized that the analysis of hypothetical estimands in clinical trials is necessary when the standard intention-to-treat (ITT) analysis does not answer the decision problem, usually because of treatment switching. An innovative framework for causal inference methods, target trial emulation, causal estimands and causal modeling guides the design and analysis of observational studies and clinical trials. This course will (1) introduce causal principles, causal diagrams (directed acyclic graphs; DAGs), and target trial emulation to avoid self-inflicted biases (e.g., time-zero bias, immortal time bias), (2) provide an overview of causal methods for baseline confounding (multivariate regression, propensity scores) and time-varying confounding (e.g., g-formula, marginal structural models with inverse probability of treatment weighting, and rank-preserving structural failure-time models with g-estimation), (3) propose appropriate estimands to ensure decision problems are directly addressed when analyzing observational data or data from clinical trials affected by treatment switching, (4) present lessons learned from applied case examples in HTA, such as single arm-trials with external control arms or trials affected by treatment switching, (5) provide recommendations regarding the use of causal inference methods and estimands and their application in causal modeling, and (6) discuss acceptance and barriers from an HTA agency perspective. The target audience includes all stakeholders and researchers from all fields in health and healthcare.
PREREQUISITE: Students are expected to have a basic knowledge in epidemiologic studies and methods (including the concept of confounding).
Felicitas Kuehne, MSc
UMIT - University for Health Sciences, Medical Informatics and Technology, Institute of Public Health, Medical Decision Making and Health Technology Assessment, Innsbruck, Austria
Nicholas R Latimer, PhD, MSc
University of Sheffield & Delta Hat Limited, Sheffield, United Kingdom
Uwe Siebert, MD, MPH, MSc, ScD
UMIT TIROL - University for Health Sciences and Technology Hall in Tirol, Austria and Harvard Chan School of Public Health Harvard University, Hall in Tirol, Austria
Gain new skills in the use of real-world evidence (RWE) in external control arms (ECAs) – an advanced application that has become critical in drug development. During this course you will learn more about the history and regulatory landscape of the application of ECAs and how to analyze the current regulatory and payer landscape for ECA acceptance and application in drug development and market access. You will explore the relevant data sources and sourcing methodologies for ECAs and learn how to develop external control arms using synthetic data and data from multiple data sources. End the course by designing and developing an external control arm with your peers.
PREREQUISITE: To get the most out of the course, students should be familiar with basic definitions and concepts of RWE including regulatory applications.
Ulka Campbell, PhD, MPH
Aetion, Inc, New York, NY, USA
Doug Foster, MBA
Advanced Data Sciences, San Francisco, CA, USA
Aaron Kamauu, MPH, MS, MD
Navidence LLC, Bountiful, UT, USA
Leanne Larson, MHA
ZS Associates, Wilmette, IL, USA
Track: Economic Evaluation
This highly practical course will outline the computational and transparency advantages of using R, for those used in health economic modelling using Microsoft Excel. This course explores the use of R for health economic modelling in the context of health economics and outcomes research (HEOR) and faculty will guide the participants through practical examples of HEOR. The faculty are expert speakers who have diverse experience in academia, national Health Technology Assessment agencies (NICE, NCPE), and industry. The faculty will lead participants through practical examples of health economic modelling including using R for Markov models from deterministic analysis through to probabilistic sensitivity analysis and EVPI. Additional useful packages for modelling using R will also be discussed. All sessions will interchange between descriptive lectures and hands-on exercises. Participants will be provided with materials, including model examples in R and information on where to go for further learning. This course is designed for those with some familiarity with modelling techniques, such as the concepts of discrete time cohort Markov models and probabilistic sensitivity analysis, but familiarity with R coding is not required. Attendees will require a laptop with RStudio (v1.1.0 or higher) and R (v4.2.1 or higher) downloaded and installed.
Gianluca Baio, PhD
University College London, London, United Kingdom
Rose Hart, PhD
Lumanity Inc., Sheffield, United Kingdom
Felicity Lamrock, PhD
Queens University Belfast, Belfast, ANT, United Kingdom
Howard Thom, MSc, PhD
University of Bristol, Bristol, United Kingdom
In this course, participants will be introduced to the principles of what makes real-world evidence (RWE) decision-grade, including an extended example. In the first half of the course, will review the most recent RWE frameworks and guidelines, and examine case studies in which RWE was used in regulatory and HTA approval. The second half of the course is an extended example in which participants will examine a study that could support an indication expansion, and interactively discuss how choices made in the design and implementation may affect the meaning and interpretability of results.PREREQUISITE: Students are expected to be familiar with relevant concepts and methodologies for analyzing real-world data.
Jeremy Rassen, ScD
Aetion, Inc., New York, NY, USA
Sebastian Schneeweiss, MD, ScD
Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
Shirley Wang, PhD
Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
This course is designed to teach clinicians and new researchers how to incorporate health economics into study design and data analysis. Participants will first review the basic principles and concepts of health economic evaluations, then discuss how to collect and calculate the costs of different alternatives, determine the economic impact of clinical outcomes, and how to identify, track, and assign costs to different types of healthcare resources used. Different health economic models and techniques will be demonstrated including cost-minimization, cost-effectiveness, cost-benefit, cost-utility, and budget impact analysis. Decision analysis, sensitivity analysis, and discounting will all be demonstrated and practiced. This course is suitable for those with little or no experience with health economics.
Lorne Basskin, PharmD
Strategic Economics Ltd., Cary, NC, USA
Karen L Rascati, PhD, RPh
The University of Texas at Austin, Austin, TX, USA
Unlike marketing authorization for pharmaceuticals, mainly regulated at the European level by EMA, pricing and reimbursement decisions in Europe are managed by individual member states. Health care services are generally covered by a single public health insurer operating under the Ministry of Health supervision. As a monopoly buyer, this situation provides a leading position for the public health insurer to set reimbursement conditions. Therefore, based on each country’s set of regulations, processes, and values, wide variations exist in pricing and reimbursement decisions of pharmaceuticals. Using up-to-date governmental regulation sources, learn about health technology decision-making processes for reimbursement decisions for pharmaceuticals in France, Germany, Hungary, Italy, Poland, Spain, Sweden, and the UK. The course will describe these reimbursement systems, as well as compare, and bring into contrast their key characteristics. This course is designed for individuals with intermediate experience within a single healthcare system wishing to broaden their appreciation of other reimbursement systems.
Mondher Toumi, MD, PhD, MSc
Laboratoire de Santé Publique Aix-Marseille University, Marseille, France
Historically, economic models for cost-effectiveness analyses have been developed with specialized commercial software (such as TreeAge) or more commonly with spreadsheet software (almost always Microsoft Excel). But more recently there has been increasing interest in using R and other programming languages for cost-effectiveness analysis which can offer advantages regarding the integration of input parameter estimation and model simulation, the evaluation of structural uncertainty, and the quantification of decision uncertainty, among others. Programming languages such as R also facilitate reproducibility of model-based cost-effectiveness analysis which is more relevant than ever given recent calls for increased transparency. While these tools are still relatively new, there is an increased interest in learning opportunities as evidenced by recent tutorials, workshops, and development of open-source software.
In this short course, participants will learn how to use R to develop a number of different types of economic models to perform cost-effectiveness analysis. Economic models will include time-homogeneous and time-inhomogeneous Markov cohort models, partitioned survival models, and semi-Markov individual patient simulations. The underlying assumptions of each model type will be summarized and the implementation in R will be presented in an accessible manner. Participants will be asked to modify the models in R (eg, adding health states, use of alternative time-to-event distributions) and run analyses (eg, cost-effectiveness analysis, probabilistic sensitivity analysis, evaluating structural uncertainty, and value of information analysis). To make this interactive aspect of the course as efficient as possible, all participants will have access to the GitHub repository prior to the course. It will contain R code to run the economic models and R Markdown files to explain and reproduce the analyses covered in the course.
Devin Incerti, PhD
EntityRisk, Inc., San Francisco, CA, USA
Jeroen Jansen, PhD
Department of Clinical Pharmacy, School of Pharmacy, University of California – San Francisco, USA; PrecisionHEOR, Oakland, CA, USA
Track: Study Approaches
This course delves into the transformative role of Generative AI, particularly large language models (LLMs), in enhancing key areas of HEOR such as systematic literature reviews (SLR) and real-world evidence synthesis, economic modeling, regulatory decision-making, and the development of external control arms.
Participants will learn to apply Generative AI technologies to conduct comprehensive and efficient systematic literature reviews, synthesize evidence at scale, and construct robust economic models that support healthcare policy and market strategies. The course also covers the strategic use of AI in developing external control arms, essential for clinical trials and regulatory submissions, thereby improving the quality and speed of healthcare decisions.
This program is ideal for HEOR data analysts, outcome researchers, epidemiologist, health economists, regulatory affairs professionals, and anyone in all substance matter fields involved in the planning and implementation of healthcare strategies. Through a combination of expert lectures, hands-on exercises, and case study analyses, attendees will gain practical skills and insights into leveraging AI to streamline research processes, enhance data analysis, and forge ahead in the dynamic field of healthcare research and policy. Participants are required to bring a laptop with the capability to connect to Wi-Fi and sufficient processing power to handle basic analytical tasks. For conducting SLR, participants may need access to databases such as PubMed, Cochrane Library, or Embase.
PREREQUISITE: Students are expected to have a basic knowledge of HEOR concepts, health data analysis, research methods, and interest in artificial intelligence.
Turgay Ayer, PhD
Georgia Institute of Technology, Atlanta, GA, USA
Jagpreet Chhatwal, PhD
Harvard Medical School, Boston, MA, USA
Xiaoyan Wang, PhD
Tulane Univeristy, New Orleans, LA, USA
Hua Xu, PhD
Yale University School of Medicine, New Haven, CT, USA
This short course is designed for professionals with a basic understanding of health technology assessment (HTA) who seek to deepen their knowledge and skills in evaluating interventions for rare diseases. Participants will gain an appreciation of the unique challenges that rare diseases pose for HTA due to limited evidence, small patient populations, and high treatment costs. A case study from Europe will be shared. The session will close with a discussion on the methodological challenges of HTA in rare disease.
Josh Byrnes, PhD, MHEcon, BEcon
Griffith University, Brisbane, QLD, Australia
Giuseppe Caputo, BSc (Hons)
Vista Health Pte Ltd., Singapore, Singapore
Hwee-Lin Wee, PhD
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Track: Patient-Centered Research
This course provides an in-depth discussion of the steps needed to successfully implement patient-reported outcomes (PRO) measurement within the drug development program to generate data to support patient-centered value messages. Formulation of a successful PRO strategy requires an understanding of PRO instrument selection, psychometric evaluation, data capture, and interpretation to negotiate regulatory, reimbursement, and market access drug development hurdles. Judging PRO instrument quality and appropriateness can be challenging.
The course will present the key elements to consider at each step in reviewing and selecting PRO measures and determining the need for new instruments. In addition, participants will gain a better understanding of regulatory expectations for qualitative and quantitative evidence to support the quality of PRO measures and aspects to consider when interpreting meaningful change. The course will include interactive discussions of PRO success stories and common pitfalls to watch out for during PRO implementation in clinical trial programs.
Participants will gain the knowledge and skills required to take on a more active and confident role in the PRO strategy and implementation process.
PREREQUISITE: This course assumes that participants will have a basic knowledge of key PRO-related concepts (eg, health-related quality of life, symptoms, impacts, a general knowledge of the PRO development steps, and a working knowledge of PRO measurement within clinical programs.)
Rebecca Crawford, MA
RTI Health Solutions, Manchester, United Kingdom
Lynda Doward, MRes
Ari Gnanasakthy, MSc, MBA
RTI Health Solutions, Succasunna, NJ, USA
Shanshan Qin, PhD
RTI Health Solutions, Durham, NC, USA
Nicholas J. Rockwood, PhD
RTI Health Solutions, Bend, OR, USA
Healthcare data are often available to payers and healthcare systems in real time, but are massive, high dimensional, and complex. Artificial intelligence and machine learning merge statistics, computer science, and information theory and offer powerful computational tools to enhance the extraction of useful information from complex healthcare data and prediction accuracy. This course gives an overview of basic machine learning concepts and introduces a few commonly used machine learning techniques and their practical applications in healthcare and pharmaceutical outcomes research. Participants will be introduced to foundational principles and concepts of statistical machine learning, then be provided with several specific machine learning techniques and their applications in health and pharmaceutical outcomes research. The course faculty will use R or Radiant to demonstrate several machine learning methods such as penalized regression and tree-based methods, as well as techniques for dimension reduction/feature selection. Participants will have hands-on practical experiences with machine learning and gain experience interpreting and evaluating the results and prediction performance that comes from machine learning modeling. Distinguishing prediction modeling from causal inference research in pharmacoepidemiology will be also presented and discussed. This is an entry-level course but is designed for those with some familiarity with traditional statistical modeling techniques (eg, linear regression, logistic regression).
PREREQUISITES: To get the most out of the course, students should have a basic statistical background. Participants who wish to gain hands-on experience are required to bring their laptops with Radiant (https://radiant-rstats.github.io/docs/install.html) installed.
Wei-Hsuan Jenny Lo-Ciganic, PhD, MSPharm, MS
University of Pittsburgh, Pittsburgh, PA, USA
William Padula, PhD, MSc, MS
University of Southern California, Los Angeles, CA, USA
Survival modeling techniques are commonly used to extrapolate clinical trial outcomes like overall survival to a time horizon that is appropriate for health economic evaluations. Standard parametric distributions, such as the exponential and Weibull, have been the de-facto standard for conducting such extrapolations but, with the advent of novel potentially curative therapies, these standard parametric distributions fail to capture the underlying survival trend. Newer techniques like parametric mixture, mixture-cure, and non-mixture cure models are among novel ways to capture these more complex survival patterns. In addition, the incorporation of external evidence has gained prominence. The purpose of this course is to enable participants to identify which methods are most appropriate in a specific context, considering underlying structural assumptions, and discuss how modeling choices propagate into health economic evaluations. To gain a more in-depth understanding of the impact of the choice for a specific method, there will be walkthroughs of exercises which participants will be able to practice in their own time.
PREREQUISITE: Participants must have a basic understanding of Kaplan-Meier curves, standard survival modeling techniques, such as a Weibull distribution in a partitioned survival framework, and R in order to follow along with the exercise walkthroughs.
Elisabeth Fenwick, PhD
OPEN Health Evidence & Access, Oxford, United Kingdom
Bristol-Myers Squibb, Utrecht, ZH, Netherlands
Claire Simons, PhD, MSc, MMATH
OPEN Health - HEOR and Market Access, York, NYK, United Kingdom