Posts Tagged Market Access

An Englishman in New York

Part I: A letter from America.

Andrew Briggs  by Professor Andrew Briggs

“A cynic knows the price of everything but the value of nothing.”
Oscar Wilde, Lady Windermere’s Fan

 

HealthcareReformAs a left-leaning economist with a bachelor’s degree in economics from a liberal arts college (or what might be considered the UK equivalent) I have always had a morbid fascination for the market-based economy of the United States.  While I loathe, in the philosophical sense, the emphasis on the individual in the US, the inequality, the apparent lack of federal support for higher education and health care, I have always enjoyed travelling to the states, meeting the people, enjoying the hustle and bustle.  And I have always been fascinated by the fact that despite the apparent inequalities in the US health system, many of my US friends and colleagues are convinced that the US has the greatest health care in the world, and they seem profoundly suspicious of ‘European-type’ systems of social medicine.

 

So after 10 years running a small Health Economics and Health Technology Assessment research group at University of Glasgow, when the opportunity for a sabbatical presented itself, spending a year in the US to learn more about your health system, seemed an obvious choice.  The widespread rejection – at least at the system level – of metrics such as the cost-per-Quality-Adjusted-Life-Year (QALY) that have gained widespread acceptance in the UK – deserved further inspection.  This is a metric that generates such profound fear among some sectors of US society that it was felt necessary to outlaw its use under the Affordable Care Act – at least for services provided by CMS http://bit.ly/29VbLUk.  Indeed, such is the fear of socialized medicine that the US Preventative Services Task Force is itself prevented from explicit discussion of cost when making recommendations about national screening strategies http://bit.ly/2aftHrJ .

 

Dr. Peter Bach

But where to go in the US and what to focus on?  After a close call with the commonwealth fund’s Harkness fellowship scheme (I suspect for both them and myself – I was shortlisted but not selected)  I began a conversation with Dr Peter Bach from Memorial Sloan Kettering Cancer Center.  Peter had recently developed his DrugAbacus tool to start a discussion about runaway drug prices for oncology products.  It seemed to me that if any part of the US health system was going to crack under the strain of health care costs, it was the going to be  oncology related.  Indeed, the American Society for Clinical Oncology (ASCO) had also just released another framework for looking at value.  But this sudden focus on value: isn’t that precisely what we have been trying to do in Europe for the last twenty or so years?  Yet it was clear the cost-per-QALY framework was not a contender – so what are these value frameworks about and do they have any credibility in terms of traditional economic thinking?  So a focus for the sabbatical was born and with Peter and MSKCC playing host, I was all set.

 

Arriving in New York in December of 2015, Peter immediately bundled me off to a two-day ‘Health Care Summit’ organized by the Forbes media group, where he had just five-minutes in a packed program to talk about drug prices in oncology.  This was a fascinating induction into the US system.  It quickly became clear that unlike the academic conferences I was used to – this was a health care business conference, with CEOs from all kinds of health related activity both on the stage and in the audience.

Martin_Shkreli_House_Committee_on_Oversight_and_Government_Reform_2016

Martin Shkreli

Most newsworthy were the two key interviews live on stage with Martin Shkreli of Turing Pharmaceuticals and Elizabeth Holmes of Theranos.  When asked if he had any regrets about his strategy on raising the price of Daraprim, Shkreli replied “Yes, not raising the price even higher”, which was accompanied by a collective sharp intake of disgusted breath from the audience.  This was a baptism of fire into the realities of a US system where excessive profits are seen as legitimate, but profit gouging is not (though most would favour self regulation rather than any federal intervention).  Before the end of the year Shkreli had been arrested – though for an alleged Ponzi scheme related to his previous hedge fund business – not for his pharmaceutical business (from which he has now resigned as CEO).  Less dramatic perhaps, but no less important, was Elizabeth’s defence of the new finger prick drug tests offered by her company.  Having raised an astonishing $700M in capital for the idea against a reputed $9B valuation – Theranos was running into trouble with the FDA over whether results against competitors blood tests had been properly validated.  Six months later and it has become clear that there is a fundamental problem with Theranos’s ‘disruptive technology’ and Holmes has now been barred from owning a diagnostic company by CMS for the next two years.

 

AB_CALLOUT_ONEAside from the headline grabbing CEOs, the real message for me of the conference was around new technological solutions to manage the huge information requirements of the US system.  Integration of electronic medical records, hospital accounting systems and billing information seems to offer the potential for streamlining and cost-saving with many new companies entering the space between the provider and the payer.  This raises a fundamental question of who owns these data, and what else, beyond cost-savings, this information might be used for.  The possibility of ‘big data’ leading to real benefits for the health system, as well as individual patients, remains intriguing.  And quips about the similarity between big data and teenage sex aside, it is an area where we might hope to see real improvements over the coming years.  But to do so, we need to see much, much more transparency.

 

Nationalflagonstethoscopeconceptualseries-UnitedStatesAs I started my sabbatical in the US, one question arose more than any other when people asked about my initial reaction to the US system.  “What surprises you most about US health care?”.  That was surprisingly easy to answer.  As a UK economist, brought up on the notion that the US prefers market-based solutions more than socialised, government regulated, solutions, it seems to me, and in direct contrast with the Oscar Wilde quote above, that consumers in the US health care system do not know the cost of anything – at least not prior to the point at which they have to choose whether to consume it.  The lack of price transparency in the US is astonishing.  Without an understanding the cost of health care, how can we hope to get a handle on value?

 

Written by Andrew Briggs, DPhil, MSc. Visiting Investigator, Center for Health Policy and Outcomes, Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY,

Chair in Health Economics (Health Economics and Health Technology Assessment), University of Glasgow

 

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How Much Do HEOR Professionals Make?

I wish the buck stopped here. I could use a few.  That sounds a little like a Henny Youngman one-liner, doesn’t it?

Could you use a few more bucks?  Do you know if your salary is fair or can you justify a higher salary?  If you’re a hiring manager, do you know if your company compensation is appropriate for recruiting the best talent, and retaining employees who are happy, secure, and satisfied in their job?

If you work in the Human Resources or Talent Acquisition field in the pharmaceutical or health care industry, you probably struggle to find highly experienced individuals.  And, if you’re further focused in the health economics and outcomes research (HEOR), market access, health data analytics, or epidemiology area, you are in an even more selective group.

HEOR Salary Survey from HealthEconomics.Com

HealthEconomics.Com recognizes that salary and compensation data are essential – but generally absent, minimal, or outdated – in this HEOR & Market Access field, particularly from a global perspective covering various company sectors.  Therefore, HealthEconomics.Com in concert with Medlitera.Com, just released the final report based on the industry’s largest global salary survey for the HEOR and market access community.  Results are now available for purchase.

To view the Executive Summary and a complete Table of Contents, click here.

 

The Survey presents results on 475 individuals from 5 continents and 30+ countries, reflecting 2015 compensation rates.  The Final Report is 65 pages long, with 61 charts/figures, and extensive cross-tabulation analysis.  No other Salary Survey provides such an extensive respondent base, geographic reach, or analytic approach.

Key Questions That This Salary Survey Answers:

  1. What is the median base salary for HEOR professionals?
  2. How does salary vary by job title, job sector, education, age, degree, years of experience, company type, and geography?
  3. How much is a typical bonus, and how does this vary by job title, job sector, and geography?
  4. What benefits packages are typically offered, and how does this vary by company type?
  5. Are HEOR professionals satisfied in their job, looking for new employment, or concerned about discrimination?
  6. What are the key factors for professional success?
  7. Is gender and racial discrimination occurring in our industry, and how is it manifested?

What organizations participated?

Employees who completed the Salary Survey hailed from a variety of organizations, including Amgen, Astellas, astrazeneca, Baxter, Biogen Idec, BristolMyersSquibb, Boehringer Ingelheim, Celgene, Decision Resources Group, Evidera, GFK, GalbraithWight, J&J, Kantar Health, Lilly, Merck, Novartis, Pfizer, Xcenda, among others.

Sneak Peak at Results:

Here’s a sneak peak at the data from the 2015 Global Salary Survey for HEOR & Market Access.

At the time of the survey (March 2015), respondents had a mean age of 42 years, had been working in the HEOR field for a median of 10 years, and 56% were male, while 71% were Caucasian and 19% were Asian. Sixty-five percent were based in the United States, 14% in the UK, and 11% in Europe.  Asia and Latin America were home base for 3% of respondents. More than one-third (36%) had PhDs, and 37% had master’s degrees of some type.  About 13% claimed an MD/PharmD degree.  About 40% were employed in biopharma, and 30% worked for a consulting/CRO group.  Seven out of 10 specifically identified HEOR/market access as their primary job function, and another 17% were in related (Medical Affairs, Pricing/Reimbursement, etc.) functions.  One-half were Director level or above, and one-third were Analyst/Manager level; 59% had direct budget management responsibility.

The gross base salary from the primary job, based on 403 respondents, is shown below.  This figure excludes bonuses, commission, or other financial benefits.

Base Salary of HEOR & Market Access Professionals, 2015

 

General trends based on the results from the survey are:

  • Median base salary (excluding bonuses, commission, or other financial benefits) for all respondents was $125,000-$150,000.
  • Overall, respondents working within the pharmaceutical/biotech sector reported a higher base salary range (about $25,000 difference) than those working in other sectors.
  • Medical device and managed care respondents reported salaries ranging from $125,000 to $150,000, the second highest median level.
  • Medical Affairs and Market Access positions garnered higher salaries than HEOR.
  • There is approximately a median $50,000 increase in salary in moving from Assistant/Associate Director to Director/Senior Director, and again to VP level.
  • Males tend to make approximately $25,000-$50,000 more than females in the higher level positions.
  • Mean number of benefits offered was 8.9 in biopharma, 7.5 in CROs, and 6.0 in consulting.
  • About 40% of bonuses ranged from $10K-$50K.  Specific bonus amounts, by experience, job title, company type, and geography are found in the Final Report.
  • More than one-half of respondents had very flexible work schedules; and 80% were able to work remotely at least 1 day per week.  But the vast majority worked late or on weekends.
  • Discrimination probably needs some investigation.  Almost one-fourth had either experienced or knew someone who had experienced gender discrimination in the HEOR field, while 16% reported personal or knowledge of racial/ethnic discrimination.

Additional cross-tabulations in the Final Report, available for purchase here, include:

  • Base salary, primary and secondary job
  • Salary by age and job sector
  • Salary by experience (current job) and job sector
  • Salary by experience (total HEOR) and job sector
  • Salary by job level and job sector
  • Salary by job function and job sector
  • Salary by company size and job sector
  • Salary by country and job sector
  • Salary by US region and job sector
  • Salary by race/ethnicity
  • Salary by gender and job sector
  • Salary by gender and job level
  • Salary by education level
  • Raise, date last received
  • Raise, amount (%, median) received
  • Salary review, date expected
  • Job promotion, date received
  • Happiness with income
  • Salary appropriate for job
  • Benefits, type and mean number received
  • Benefits (type) by job sector
  • Bonus range by job sector
  • Salary satisfaction by salary and job sector
  • Job satisfaction by salary and job sector
  • Career training by salary and job sector
  • Work flexibility
  • Job stress
  • Remote work-days per week
  • Overtime and weekend work
  • Happiness with current job
  • Happiness with career training
  • Plans to leave job in next 12 months
  • Gender discrimination, occurrence & type
  • Race/ethnicity discrimination, occurrence & type

To learn more about the 2015 Global Salary Survey for HEOR & Market Access, visit here:  http://www.healtheconomics.com/home/order-your-2015-global-salary-survey/ or contact me, Dr. Patti Peeples, at patti@healtheconomics.com.

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