Upskilling: The New HEOR Imperative

By Beth Fand Incollingo

Over the past 2 decades, health economics and outcomes research (HEOR) has evolved into a cornerstone of healthcare decision making. Key trends include the rise of real-world evidence (RWE) to complement clinical trials, a shift toward value-based care, and greater emphasis on patient-centered outcomes. Through this time, HEOR has gained global influence in health technology assessments (HTA) and policy shaping. A new era of rapid change is upon us—driven by more sophisticated methodologies incorporating artificial intelligence (AI) and advanced modeling techniques.

That’s the way Louise Parmenter, PhD, global head of scientific services, real-world evidence at IQVIA, sums up the changes affecting experts across the HEOR workforce.

In addition to the emerging use of AI to streamline tasks in a variety of settings, HEOR is being reshaped by regulatory and policy changes. The most notable include the European Union’s new joint clinical drug assessment process and the Centers for Medicare and Medicaid Services’ final guidance for drug price negotiation.¹ There are RWE policy developments neatly summarized by the RWE Alliance. At the same time, HEOR professionals are being asked to work across diverse therapeutic technologies, disease areas, and health systems. As HEOR professionals strive to keep up, they’re finding the opportunities to contribute have changed.

The changes are affecting everyone from health economists and epidemiologists to psychometricians and clinicians. “In my whole career—which is decades, not years—this has probably been the time of the most change,” said Parmenter, who is based in the United Kingdom. “That makes things interesting but presents challenges. So, I’m mindful about that with the workforce I lead.”

With so many changes afoot, strengthening crucial skills is paramount, and there are many ways for professionals to do that, including through collaboration between academic and private organizations, Parmenter said. She added that IQVIA, a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries, offers training to help its workforce stay up to date. HEOR professionals can also learn in courses offered by professional organizations such as ISPOR, which provides educational programs and Professional Development Resources.

“In addition to new regulations and guidelines, there’s a huge pace of acceleration of methods, approaches, scientific innovation, and evolution,” Parmenter said. “Employees need to stay current on the best methods for conducting research and forward thinking on how AI will evolve their roles.”

Constant Change Is Here to Stay

Now that the Great Resignation² has subsided, Parmenter has seen a new stability in how the HEOR workforce is distributed.

During the pandemic, “HEOR experts moved around a lot,” she said. “Now, much of that has settled, with levels of movement that are slightly below what we’d expect as an average.”

Unfortunately, there may be fewer employment opportunities than there were 10 or 15 years ago, when the HEOR field experienced a boom,³ said Christopher Blanchette, PhD, MBA, vice president for clinical data science and evidence at Novo Nordisk.

While Parmenter is seeing demand for HEOR expertise from countries with HTA bodies or government-run copay systems,⁴ Blanchette has noticed a trend toward layoffs in the pharmaceutical industry.⁵ Company-wide layoffs are often responses to drugs going off patent, he said, but cutbacks that specifically target HEOR functions highlight the need for such groups to better measure and communicate how they’re meeting stakeholders’ needs.

“When HEOR groups become sizeable, companies sometimes question their return on investment, and, unlike with sales departments, it’s hard to pinpoint that,” said Blanchette, who oversees teams in the United States and Mexico. “You need people in HEOR to grow into strong leaders who communicate that, and then they need to empower the people under them to be more effective at communicating and delivering that message across the organization.”

“In addition to new regulations and guidelines, there’s a huge pace of acceleration of methods, approaches, scientific innovation, and evolution. Employees need to stay current on the best methods for conducting research and forward thinking on how AI will evolve their roles.”— Louise Parmenter, PhD

Blanchette added that tariffs and recent cuts to health-related regulatory bodies by the US government⁶ may have resulted in some job loss across HEOR and could lead to more, due to a cascade that will first affect pharmaceutical companies and then reach consulting groups, researchers, academics, investors, and biotechnical startups.

Turbulence across the field is just as much a factor for those already engaged in HEOR work. For instance, Parmenter said, since the European Union began conducting HTAs as a unified entity in January 2025,⁷ HEOR workers have been called upon to enter the process earlier, learn new ways to present clinical information, and collaborate with the regulatory bodies of multiple countries at once.

In addition, the work of HEOR professionals must incorporate new guidelines released by many countries around the use of RWE,⁸ and must account for a related initiative — the European Medicines Agency’s Data Analysis and Real World Interrogation Network, or Darwin EU, which provides compiled data that can be used by the EMA and national competent authorities in the European medicines regulatory network whenever needed throughout the lifecycle of a medicinal product.

“Decision makers now have direct access to safety and effectiveness data, and that’s a change that helps with efficiency,” Parmenter said of Darwin. “Nevertheless, there will continue to be strong demand for HEOR expertise, because the whole field has become more complex.”

You Can’t Spell “Transformation” Without “AI”

As perhaps the field’s biggest disruptor, AI presents the workforce with both challenges and solutions. The key is in learning to understand and apply the technology.

Rachael Fleurence, PhD, who leads global evidence and AI solutions initiatives at Value Analytics Labs after a public health career that included a post at the National Institutes of Health, called the introduction of the technology “a watershed moment.”

“Compared with 30 years of incremental changes,” she said, the technology is “the most disruptive we’ve had for a long time.”

Fleurence is excited about AI’s ability to make HEOR projects not only more comprehensive and effective, but also more streamlined, so that workers will have more time for other tasks.⁹

“You need people in HEOR to grow into strong leaders and they need to empower the people under them to be more effective at communicating and delivering that message across the organization.”— Christopher Blanchette, PhD, MBA

Currently, she’s overseeing 2 literature reviews that are employing AI to assist with screening, data extraction, and report writing. Her company is also testing AI’s ability to generate economic outcomes decision-making models.

In addition, Value Analytics Labs has developed ValueGen.AI, a platform that can generate automated, disease-specific landscape reviews for pharmaceutical and medical technology companies.¹⁰ The reviews summarize the market, competitors, HTA decisions, demographics, epidemiology, and the pipeline—with information being gathered much more quickly than in the past.

“Before, you’d have folks on the team going through thousands of abstracts manually to see if they should be included in a review, but AI is able to rank the abstracts so humans can see which should most likely be included first and which should most likely be excluded,” Fleurence said. “You can really save months of work.”

IQVIA has also agentified its literature review process. In addition, employees are using AI to do medical and scientific writing. The potential benefits are huge, including making it easier for subject-matter experts across a host of countries to partner in writing clinical study reports or value dossiers, speeding time to delivery and improving quality. But it does not end there; AI makes what was impossible for humans possible,  with the potential to manage scale and pace of change in ways previously unimaginable.

“There will continue to be strong demand for HEOR expertise, because the whole field has become more complex.”— Louise Parmenter, PhD

On the horizon, Fleurence envisions living HTA assessments, which instead of being compiled and shelved will be systematically updated via AI as new drugs enter the market.

Both companies are being cautious, however, to ensure that there’s always a human in the loop to guide AI and gauge its success. “We’re still doing a lot of human validation, because these are new tools and their output needs to be scientifically valid,” Fleurence said. “The exciting part is that it does seem like generative AI is quite helpful.”

Professional Development Is a Necessity

So, how can the HEOR workforce keep up?

The key, Parmenter said, is professional development. “With the environment changing from the regulatory, methods, and technology standpoints, none of us can be complacent,” she said. “We all need to see ourselves as being on a journey of continuous learning.”

That’s why every HEOR professional seems to have a voluminous reading list, she said, which is helpful but can make it difficult to know what to tackle first. “If you just look on the internet, you can access a lot of technological training, but it can be a bit overwhelming,” she said. “What’s interesting is that you can actually use AI to summarize the information in a more digestible way.”

Parmenter recommended that HEOR professionals also increase their knowledge by collaborating with colleagues. At conferences and through organizations like ISPOR, the International Society for Pharmacoepidemiology (ISPE), and the Drug Information Association (DIA), she said, IQVIA encourages team members to teach courses alongside colleagues from academia, industry, service-providing organizations, and regulators, as well as attending classes.

“Compared with 30 years of incremental changes, [AI is] the most disruptive we’ve had for a long time.”— Rachael Fleurence, PhD

“One of the nicest ways to advance thinking and methods is this kind of collaboration across institutions, bringing those different perspectives together,” she said. “It can accelerate learning and lead to some of the best papers—the type that end up being cited again and again.”

After educational events, IQVIA asks those who participated to spread their new knowledge throughout the company via internal symposiums. Likewise, employees who publish their findings offer seminars to IQVIA’s teams.

“In a monthly continuing scientific education series, speakers tell us about the latest analytic methods or approaches,” she said, “and we also have centers of excellence that promote best practices in changing regulatory and payer environments. The only way to stay abreast of all that is to keep learning and to participate in some way, whether that means submitting a poster to a conference or finding a mentor within our organization.”

IQVIA also circulates a twice-yearly newsletter to inform employees about new regulations and guidelines, and it trains employees to use AI through a program that awards color-coded belts for increasing levels of expertise.

AI adoption is being actively encouraged through active soliciting of AI use cases, pilots, and a formal roll-out and change management process to accelerate transformation.

In the larger HEOR community, Blanchette hopes to eventually see collaborations between the nonprofit and academic sectors to create what he believes is missing in professional development: high-level courses that teach senior HEOR professionals “the soft skills of business and communication, such as how to interact with boards and how to work through mergers and acquisitions.”

For those just starting out, technical skills should be the primary focus, and that’s why university students should increase their value by doing everything they can to absorb AI techniques, added Blanchette, a former associate professor at the University of North Carolina at Charlotte.

Parmenter cautioned, though, that even the newest job candidates might need some professional development. “We have quite a few internship schemes that we offer in India, Portugal, the United Kingdom, the United States, and elsewhere,” she said, “which enable us to work with local universities to understand what individuals have learned and then bring in a cohort of employees to give them the extra training they might need.”

Growing Pains for Pharmaceutical Teams

Many of the supports available to the HEOR workforce involve collaboration, but is it possible for that effort to go too far?

There has been some debate about recent decisions by pharmaceutical companies to disband their HEOR groups and embed members across other departments.

Parmenter thinks the trend could be a response to HEOR experts being needed earlier and more consistently throughout the drug-development process now that RWE is so often used to supplement phased clinical trials.

But Scott D. Ramsey, MD, PhD, director of the Hutchinson Institute for Cancer Outcomes Research at Fred Hutch Cancer Center, has expressed concern about the reshuffling because it has led to the layoffs of HEOR department heads, depleting organizational expertise.¹¹

“It’s a paradox,” Parmenter said. “The benefit of having HEOR experts together is that you get the intensity of the brain trust around the discipline and the career paths of individuals, with built-in mentoring and a clear path up the career ladder. On the other hand, people can be a little siloed in that model and disconnected from applying their scientific thinking to the business.”

“We all need to see ourselves as being on a journey of continuous learning.”— Louise Parmenter, PhD

She suggested that embedded HEOR professionals who “feel isolated from their academic homes” get involved with professional bodies like ISPOR, which “can offer the ability to remain connected while remaining close to the heart of the business you’ve been hired to support.”

No matter how HEOR professionals are deployed, Blanchette added, they are most likely to be successful if they focus on what is needed by the stakeholders they serve and work cross-functionally within their organizations to deliver it.

“Even though you’re contributing through HEOR,” he said, “you should think about how your work impacts market access, medical messaging, or commercial value.”

Changing Work Models, New Coping Mechanisms

In a rapidly changing environment, work/life balance should also remain a priority, experts agree. While Fleurence has found flexibility within her small company’s remote team, IQVIA’s global workforce includes many configurations, some of them hybrid. To get a sense of how that’s working out, IQVIA runs surveys at least twice a year to uncover and address employee stressors.

“Within our company, every country runs its own wellness program,” Parmenter said. “In India, there’s a fund for teams to go away and have days out from work. In other parts of the world, the local office might have a summer fair or a holiday party. And teams anywhere might have Friday coffee events.”

The same kinds of initiatives, she said, along with perks such as employer-sponsored gym memberships, are being implemented for HEOR workers across the field. And at most companies, Parmenter said, mental-health helplines are part of employment packages.

“In some ways, it’s harder now with hybrid working to manage the well-being of a workforce, because we don’t see people as often,” she said. “However, it’s something we need to continue to focus on, because this can be quite a complex world to navigate while balancing all our responsibilities.”

References:

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Beth Fand Incollingo is a freelance writer who reports on scientific, medical, and university issues.