OBJECTIVES:

To identify the impact of utilizing Integrated Delivery Networks (IDNs) and their in-house resources in fulfilling HEOR program requirements (i.e. BI models, cost offset analyses, value based or outcomes-based agreements, etc.).

METHODS:

The study was conducted through teleconference discussions with both pharmacy and medical directors within various IDN systems (n=6). The questioning focused on several different topics including: 1.) structure of the IDN and associated ability to reference specific patient level claims information; 2.) preferences for types of HEOR data; 3.) examples (positive & negative) of partnerships with manufacturers to achieve HEOR program criteria; 4.) recommendations on best practices for future HEOR program partnerships.

RESULTS:

The viability of HEOR programs is often limited by the ability to both collect and track the associated data. The setup of the IDN infrastructure creates an environment where these HEOR programs can be implemented, with results attained. Depending on the disease state, HEOR programs demonstrating hospitalization reduction, ER visit reduction, or other pharmaceutical cost offsets all provide the opportunity for significant savings to the IDN. Therefore, partnerships with manufacturers are dually beneficial as IDNs are compensated for utilization of their data (and also potentially benefit in any downstream savings identified) and manufacturers are able to fulfill the requirements to complete their HEOR programs. Replication of results to managed care organizations is a subsequent step, but IDNs offer a good first prospect for assessing HEOR program impact.

CONCLUSIONS:

US IDN organizations offer a valuable initial opportunity to utilize in-house data in order to understand the impact of HEOR program success.