HOLs: The New Payer Facilitator: How Health Outcomes Liaisons Navigate Health Care Reform and Create Value within the Industry

HOLs: The New Payer Facilitator: How Health Outcomes Liaisons Navigate Health Care Reform and Create Value within the Industry



Biopharmaceutical and medical device companies in the current outcomes-focused market depend increasingly upon Health Outcomes Liaison (HOL) staff to serve as a scientific bridge with payer ...

Biopharmaceutical and medical device companies in the current outcomes-focused market depend increasingly upon Health Outcomes Liaison (HOL) staff to serve as a scientific bridge with payer organizations, thought leaders, clinical investigators and other important healthcare decision makers. As the demand for outcomes and comparative effectiveness data grows, successful companies will need to know how to fully leverage the relatively new, field-based HOL function.

Best Practices, LLC, has conducted research that will help pharma and biotech executives and managers identify how leading companies deliver exceptional HOL services in an increasingly challenging business environment. The research also examines best practices in HOL management and identifies future trends expected to impact the HOL function. Leaders burdened with headcount constraints and insufficient resources to support new products can potentially gain critical efficiencies through the shrewd use of HOLs.



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    HOLs: The New Payer Facilitator: How Health Outcomes Liaisons Navigate Health Care Reform and Create Value within the Industry HOLs: The New Payer Facilitator: How Health Outcomes Liaisons Navigate Health Care Reform and Create Value within the Industry Presentation Transcript

    • HOLs: The New Payer Facilitator How Health Outcomes Liaisons Navigate HealthCare Reform and Create Value within the Industry Best Practices, LLC Strategic Benchmarking Research Copyright © Best Practices, LLC BEST PRACTICES, ® LLC
    • Table of Contents Executive Summary pp. 3-10  Research Overview  Participating Companies  Key Recommendations  Key Findings & Insights Health Outcome Liaisons: Activities pp. 11-19 Health Outcome Liaisons: Structure & Resources pp.20-34 Health Outcome Liaisons: Differentiation of Role pp.35-41 Health Outcome Liaisons: Customer Engagement pp.42-48 Health Outcome Liaisons: Looking Ahead pp.49-54 Participant Demographic Data pp.55-59 About Best Practices, LLC pp.60 2 Copyright © Best Practices, LLC BEST PRACTICES, ® LLC
    • Research Objectives & MethodologyBest Practices, LLC explored how leading companies deliver exceptional HOL services in an evwer-changing business environment. The research also examined best practices in HOL management anddifferentiation of HOLs from other positions that serve diverse customer groups such as physicians,patients, payers, and advocates. Research Objectives:  Understand the structure and resources of Health Outcome Liaisons (HOL) programs, including staffing, budget, geographic span, oversight responsibility, and services provided  Chart the scope, frequency, and timing of HOL services  Outline methods HOLs use to engage internal and external customers and build lasting relationships  Describe how companies differentiate the roles of HOL, MSL, Key Account Manager and Sales  Identify trends expected to impact the HOL function Field Research & Insight Development: Business Objective: Research results are based upon:  Survey responses from 23 HOL program leaders Improve HOL Program at 19 different pharmaceutical and medical device Management & Maximize companies Utility of HOL Staff  Deep-dive interviews with industry veterans BEST PRACTICES, 3 ® Copyright © Best Practices, LLC LLC
    • Companies Participating in StudyThis research emerges from survey data gathered from 23 participants representing 19 leadingpharmaceutical companies. Best Practices, LLC analysts also conducted deep-dive interviews withfive participating executives to gather additional insights. Benchmark Participants Bio-pharmaceutical 92% Medical Device 4% Diagnostic 4% (n = 23) Amgen, Becton Dickinson, Boehringer Ingelheim, Cubist, Daiichi-Sankyo, Endo Pharmaceuticals, Fresenius, Genentech, GlaxoSmithKline, Janssen, Medivation, Merck & Co., Merck Serono, Pacira, Peloton, Sanofi, Sanofi Pasteur, Shire, Teva 4 Copyright © Best Practices, LLC BEST PRACTICES, ® LLC
    • Key Findings & Insights: The following key findings and insights concerning HOL program structure and budget emerged from this study. On Average, HOL Programs Are Less than Five Years Old: The majority of Health Outcome Liaison programs are in their early development, with only 25% of respondents indicating that their programs have been in place for seven years or longer. HOL Groups Often Report to Medical Affairs: More than two-thirds of respondents indicated their HOL functions report into Medical Affairs. Another 16% report to Market Access or Health Economics & Outcomes Research (HEOR) groups. Average HOL Program Has More than Seven Employees: The size of HOL programs varied across companies based on their development and differentiation of the position, with an average of 7.28 HOL employees. On average, each HOL supports 1.7 on-market products. The mean ratio of pipeline products per HOL is 1.8. Face-to-Face Talks Help Build Strong Payer Relationships: Face-to-face visits are the most important channel for building strong working relationships and credibility with decision makers. Face-to-face visits with both thought leaders and payer groups last between 30 minutes and an hour, with a little more time focused towards payer groups. Although payer groups are traditionally targeted, HOLs must deliver a strong value proposition case on the value of health economic data to both customer segments. Compliance & Regulation Will Continue to Impact HOL Role: The health care environment in the U.S. is changing rapidly and dramatically, driving an increased need for health outcomes data and for HOLs who can deliver that data to decision makers and thought leaders with clarity and impact. Currently, compliance standards for HOL activities vary across the benchmark class. Copyright© Best Practices®, LLC 5 BEST PRACTICES, ® LLC
    • HOL Groups Most Often Reports to Medical Affairs FunctionMore than two-thirds of respondents indicated their HOLs report through the Medical Affairs function,with another 16% reporting into Market Access or Heath Economics and Outcomes. HOLs shouldposition themselves further upstream in Medical Affairs as the role becomes more developed. Q. To what function does the HOL group report? HOL Reporting Structure Sales/Marketing Other (Commercial 5% Ops) 10% Market Access/Health Medical Affairs Economics & 68% Outcome Research 16%(n=19) BEST PRACTICES, 6 ® Copyright © Best Practices, LLC LLC
    • Multiple Advanced Degrees Required for HOL PositionA majority of respondents require that HOLs have some combination of PhD, PharmD, and MDcredentials. This requirement reflects the wide variety of complex responsibilities associated with theHOL position, as well as the perceived importance of the job. Many companies also seek prior clinicaland/or payer experience for the position to increase HOL credibility with decision makers. Q. What is the preferred level of education required to become an HOL at your company? (Select all that apply.) HOL Educational Demographics PharmD 72% PhD 67% MD 56% Masters 17% Degree % Responses(n=18) BEST PRACTICES, 7 ® Copyright © Best Practices, LLC LLC
    • Two-Thirds Provide Regular, Ongoing Training for HOLsTwo-thirds of benchmark participants provide regular training for HOLs, with half training quarterly orsemiannually and 17% training as often as weekly. Interviews suggested that HOL training topics reflectcustomer questions and information needs. The changing regulatory environment and the wide rangeof HOL responsibilities drive training frequency. Q. What is the frequency of ongoing training provided to HOLs? Voices from the Field: HOL Training Frequency “Probably only 60% of the time will we find No continuous clinical, payer and outcomes experience when training hiring an HOL candidate. But a gap around provided outcomes can be dealt with rather quickly 11% Semiannually through additional training within the 22% organization—such as increased project responsibility—to give them on-ground Ad hoc, 22% experience. It’s a constant evolution with no one the same.” -Interviewed Executive Quarterly “Typically, it’s one session a month devoted Weekly 28% to healthcare policy changes. Other sessions 6% are devoted to a specific product, Monthly topic, study, or competitor information.” 11% -Interviewed Executive(n=18) BEST PRACTICES, 8 ® Copyright © Best Practices, LLC LLC
    • HOL/MSL Responsibilities Are Not Always Well DifferentiatedParticipants take varying approaches to differentiating HOLs from their MSL counterparts. Manycompanies divide the roles according to the customer groups targeted, scope of work, or type ofinformation they provide. Nearly one-quarter say responsibilities overlap and roles are not distinct,while at some companies, there is a convergence of responsibilities into one overarching role. Q. How would you define the differences in responsibilities between HOLs and MSLs? (choose one) Differentiation of HOL/MSL Responsibilities Other Responses: • “HOLs are the primary interface for payer Other 35% customers” • “Combined role” There is overlap between • “Different clients”responsibilties assigned to HOLs and 24% • “MSLs and HOLs have a different set of non-MSLs, or the role differentiation is not clear. overlapping clients. Whereas MSLs provide in- depth clinical information within a dedicated When MSLs are asked technical questions pertaining to health therapeutic area, HOLs provide clinical outcomes, they ask an HOL to meet 24% information across all products, as well as with the client. health economic information” Each group manages its own field • “MSLs can talk reactively off-label, HOLs can schedule and provides differentinformation and resources to the same 17% talk proactively on-label” clients. • “HOLs call on Payer customers only”(n=17) % Responses BEST PRACTICES, 9 ® Copyright © Best Practices, LLC LLC
    • HOLs Frequently Collaborate with MSLs & Specialized MSLsDepending on geography and skill set, MSL/HOL collaborations are becoming more typical. Somecompanies are using a hybrid model, which couple HOL and MSL responsibilities. In addition,companies have begun to utilize increasingly valuable specialized MSLs known as Managed CareLiaisons to great success with the payer groups. Voices from the Field: Technical Experts “Our team is a combined HOL and MSL function. Customers want individuals who carry the portfolio Clinical Peer and can pivot between a deep clinical Talent Influencers and outcomes discussion. This group informs corporate strategy across departments.” Evidence- Based -Interviewed Executive Economic Value Proposition BEST PRACTICES, 10 ® Copyright © Best Practices, LLC LLC
    • HOLs Begin Working with a Pipeline Drug by Phase IIIAt more than half the benchmark companies, HOLs begin working with a drug at Phase III or earlier,while 37% become involved later in the development process. Companies are transitioning to involveHOLs in development earlier so their studies can benefit from decision-maker feedback that HOLscapture in the field. Q. When do your HOLs typically first work with a drug in development? Initial HOL Involvement with Drug First 12-18 Voices from the Field: Months on the Market “You need a forward-looking strategy, because as pipeline 6% Prior to Phase products come out and companies III apply pressure on the formulary, 25% ultimately, they’d rather see some of those patient outcomes be included in the original study as soon as possible instead of having to wait and put that on the marketplace and wait to see if we can fully get those Registration health outcomes or cost and Launch effectiveness later. So in other 31% words, just getting things put into the study earlier in the timeline rather than later is always a desired Phase III outcome.” 38% -Interviewed Manager (n=16) BEST PRACTICES, 11 ® Copyright © Best Practices, LLC LLC
    • HOLs Support Average of Nine In-Market Products + PipelineHOLs at participating companies support an average of 9.4 in-market products and 10.8 products inthe pipeline. Q. How many products does your company have with which HOLs are involved? Number of Products Products currently on Products in the the market: pipeline: Max 20 40 75th Percentile 12 10 Mean 9.4 10.8 Median 9 6 25th Percentile 5 3 Min 0 0 (n=21) (n=19) BEST PRACTICES, 12 ® Copyright © Best Practices, LLC LLC
    • About Best Practices, LLCBest Practices, LLC is a research and consulting firm that conducts work based on thesimple yet profound principle that organizations can chart a course to superior economicperformance by studying the best business practices, operating tactics, and winningstrategies of world-class companies. Best Practices, LLC 6350 Quadrangle Drive, Suite 200 Chapel Hill, NC 27517 www.best-in-class.com 919-403-0251 best@best-in-class.com BEST PRACTICES, 13 ® Copyright © Best Practices, LLC LLC