hols: the new payer facilitator: how health outcomes liaisons navigate health care reform and create...
DESCRIPTION
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.TRANSCRIPT
BEST PRACTICES,
®
LLC
Best Practices, LLC
Strategic Benchmarking Research
HOLs: The New Payer Facilitator How Health Outcomes Liaisons Navigate Health
Care Reform and Create Value within the Industry
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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
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Field Research & Insight Development:
Research results are based upon:
Survey responses from 23 HOL program leaders
at 19 different pharmaceutical and medical device
companies
Deep-dive interviews with industry veterans
Improve HOL Program
Management & Maximize
Utility of HOL Staff
Research Objectives & Methodology
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
Best 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 and differentiation of HOLs from other positions that serve diverse customer groups such as physicians, patients, payers, and advocates.
Business Objective:
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Companies Participating in Study
Benchmark Participants
This research emerges from survey data gathered from 23 participants representing 19 leading
pharmaceutical companies. Best Practices, LLC analysts also conducted deep-dive interviews with
five participating executives to gather additional insights.
Bio-pharmaceutical 92%
Medical Device 4% Diagnostic 4%
(n = 23)
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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
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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.
Key Findings & Insights:
The following key findings and insights concerning HOL program structure and budget
emerged from this study.
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Other
5%
Sales/Marketing
(Commercial
Ops)
10%
Market
Access/Health
Economics &
Outcome
Research
16%
Medical Affairs
68%
HOL Groups Most Often Reports to Medical Affairs Function
More 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 should position themselves further upstream in Medical Affairs as the role becomes more developed.
(n=19)
Q. To what function does the HOL group report?
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HOL Reporting Structure
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Multiple Advanced Degrees Required for HOL Position A majority of respondents require that HOLs have some combination of PhD, PharmD, and MD credentials. This requirement reflects the wide variety of complex responsibilities associated with the HOL position, as well as the perceived importance of the job. Many companies also seek prior clinical and/or payer experience for the position to increase HOL credibility with decision makers.
(n=18)
Q. What is the preferred level of education required to become an HOL at your company?
(Select all that apply.)
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17%
56%
67%
72%
Master's
Degree
MD
PhD
PharmD
HOL Educational Demographics
% Responses
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Weekly
6%
Monthly
11%
Quarterly
28%
Semiannually
22%
No continuous
training
provided
11%
Ad hoc, 22%
Two-Thirds Provide Regular, Ongoing Training for HOLs
Two-thirds of benchmark participants provide regular training for HOLs, with half training quarterly or semiannually and 17% training as often as weekly. Interviews suggested that HOL training topics reflect customer questions and information needs. The changing regulatory environment and the wide range of HOL responsibilities drive training frequency.
(n=18)
Q. What is the frequency of ongoing training provided to HOLs?
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HOL Training Frequency Voices from the Field:
“Probably only 60% of the time will we find
clinical, payer and outcomes experience when
hiring an HOL candidate. But a gap around
outcomes can be dealt with rather quickly
through additional training within the
organization—such as increased project
responsibility—to give them on-ground
experience. It’s a constant evolution with
no one the same.”
-Interviewed Executive
“Typically, it’s one session a month devoted
to healthcare policy changes. Other sessions
are devoted to a specific product,
topic, study, or competitor information.”
-Interviewed Executive
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17%
24%
24%
35%
Each group manages its own field
schedule and provides different
information and resources to the same
clients.
When MSLs are asked technical
questions pertaining to health
outcomes, they ask an HOL to meet
with the client.
There is overlap between
responsibilties assigned to HOLs and
MSLs, or the role differentiation is not
clear.
Other
HOL/MSL Responsibilities Are Not Always Well Differentiated
(n=17)
Q. How would you define the differences in responsibilities between HOLs and MSLs? (choose one)
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Other Responses:
• “HOLs are the primary interface for payer
customers”
• “Combined role”
• “Different clients”
• “MSLs and HOLs have a different set of non-
overlapping clients. Whereas MSLs provide in-
depth clinical information within a dedicated
therapeutic area, HOLs provide clinical
information across all products, as well as
health economic information”
• “MSLs can talk reactively off-label, HOLs can
talk proactively on-label”
• “HOLs call on Payer customers only”
Differentiation of HOL/MSL Responsibilities
% Responses
Participants take varying approaches to differentiating HOLs from their MSL counterparts. Many companies divide the roles according to the customer groups targeted, scope of work, or type of information 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.
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HOLs Frequently Collaborate with MSLs & Specialized MSLs Depending on geography and skill set, MSL/HOL collaborations are becoming more typical. Some
companies 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 Care
Liaisons to great success with the payer groups.
Evidence-
Based
Economic Value
Proposition
Peer
Influencers
Clinical
Talent
Technical
Experts
Voices from the Field:
“Our team is a combined HOL and
MSL function. Customers want
individuals who carry the portfolio
and can pivot between a deep clinical
and outcomes discussion. This
group informs corporate strategy
across departments.”
-Interviewed Executive
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HOLs Begin Working with a Pipeline Drug by Phase III At 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 involve
HOLs in development earlier so their studies can benefit from decision-maker feedback that HOLs
capture in the field.
(n=16)
Q. When do your HOLs typically first work with a drug in development?
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First 12-18
Months on the
Market
6%
Registration
and Launch
31%
Phase III
38%
Prior to Phase
III
25%
Initial HOL Involvement with Drug
Voices from the Field:
“You need a forward-looking
strategy, because as pipeline
products come out and companies
apply pressure on the formulary,
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
health outcomes or cost
effectiveness later. So in other
words, just getting things put into
the study earlier in the timeline
rather than later is always a desired
outcome.”
-Interviewed Manager
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HOLs Support Average of Nine In-Market Products + Pipeline
HOLs at participating companies support an average of 9.4 in-market products and 10.8 products in the pipeline.
Q. How many products does your company have with which HOLs are involved?
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Products currently on the market:
Products in the 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)
Number of Products
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About Best Practices, LLC Best Practices, LLC is a research and consulting firm that conducts work based on the simple yet profound principle that organizations can chart a course to superior economic performance by studying the best business practices, operating tactics, and winning strategies of world-class companies.
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