Real-world evidence: HealthCore’s journey
As part of an ongoing series, we are taking a look at how evidence can help us identify the health and cost impact of treatments on patients, while also highlighting areas of unmet patient needs. Earlier posts can be found here, here, here and here.
In today’s post, we talk to Marcus Wilson, the president and co-founder of HealthCore, the health outcomes research subsidiary of WellPoint, Inc. HealthCore is AstraZeneca’s founding partner in the RWE Collaboration.
How did you get become interested in real-world evidence?
Marcus: In my first job out of residency, I worked as a clinical pharmacist embedded in a group practice of 16 physicians in Delaware. There, I provided physician and patient education services, which focused on decision support. At that time, the practice was owned by a local health plan that asked me to manage their Pharmacy and Therapeutics committee, a committee made up of physicians and pharmacists who made decisions on which drugs would be reimbursed by the health plan.
As we evaluated new products for inclusion on the health plan drug formulary, it became clear that while we often had excellent evidence on how a product performed in the patients from the clinical trials, we often did not have evidence that would help us understand how the product would work on the patients covered by the health plan.
The population and treatments were often very different from those impacted most by our decision. They differed in age, race, ethnicity, severity of disease, co-morbid conditions, concomitant medication and varying levels of compliance. We needed to know the evidence related to our real world situation.
Given this lack of evidence, we began experimenting with alternative research designs and new data sources that could help us shed light on these questions.
What was your take away from this work?
Marcus: Generating real-world evidence was going to be tough. Much of the data that would be needed was originally generated for very different purposes than those of research. As such, they were difficult to manage and harder to understand and draw conclusions from about what does and doesn’t work. We also realized we needed more data – a lot more data. In fact, most questions asked of real-world data like claims data required us to start with 5 million or more lives in our database.
We set off on a quest to bring in additional research talent as well as people with extensive experience in working with the data that could help us better understand how to analyze the data and interpret the findings.
How does this factor into the work you’re doing today?
Marcus: Today, we can combine clinical information from patient charts and claims information tracking prescriptions filled, diagnostic tests, ER visits, hospital readmissions, doctor’s visits, etc. to see how drugs and other treatments are impacting patients. We can then use that information to develop interventions, make medical and drug policy decisions and help physicians and patients make better evidence-based treatment decisions.
We know we still have much to learn, but we now have an excellent learning environment and a strong collaborative research culture that allows us to work closely with the industry, health plans, physicians, regulators and academia to address some of the biggest issues in healthcare today.