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Interview with Signe Høngaard Thybo, Healthcare Partnering Manager, Health Economics at Roche Denmark

First of all, thanks for taking the time to talk to us. Can you tell us a little bit about yourself and what you do?

So, I’m an economist by training and have worked within health economics and market access for the last seven years, first in the public sector in the Ministry of Finance and The Ministry of Health in Denmark, and after that as a Global Market Access Manager in the Danish headquarters of LEO Pharma. And now I am in the Danish affiliate of Roche, where I work in health economics and market access.

You could say I am developing health economic tools but I am also talking to a lot of stakeholders on a national and a regional level to secure market access and funding for our products.

What do you see as the current commercial pressures affecting HEOR and market access?

I think we can say, as anywhere else in the Western world, it’s getting more and more difficult. First of all to obtain reimbursement but also to secure funding when the product is available to be used. Even when we have the official papers we also have to do work to ensure that the budget is available to use the product. It’s more on a local level that we see challenges.

Are there any particular challenges HEOR and commercial divisions experience when working together or communicating with each other?

Health economics is often seen as being quite mysterious…But if you use it in the right way it can be used the same way as any other tool or piece of evidence.

I think health economics is often seen as being quite mysterious. People don’t really understand it, it’s complicated, they think it’s just something that only you as a health economist can know something about.

That is sometimes an obstacle - because in the marketing department they are not always aware of what I can offer. They just see my work as extremely complicated. But if you use it in the right way it can be used the same way as any other tool or piece of evidence. One example would be if you do a study of QoL or willingness to pay - I see that as one piece in the puzzle of the whole evidence pool that you have. You can use that as evidence as well as clinical data, as long as you can communicate it so laymen can understand it.

Has BaseCase helped with communicating this kind of evidence?

I think so, very much. Before when I was using an Excel model it was more difficult for my colleagues to understand - even just the fact that you’re using Excel gets people to back off. But if you translate it into something that’s nice looking, easier to use or doesn’t remind people of a spreadsheet then it’s easier to digest.

It’s also useful because the ones that will be using the models we develop in BaseCase are hospital account managers primarily – our sales reps – I might join them on some visits, but they will be the ones using them. To be honest, they are not very confident using an Excel model that they haven’t developed themselves in front of a customer. So it’s easier to get them on board when they have this app interface to work with.

What do you think are the challenges in discussing HEOR data with payers and healthcare providers in your country?

Denmark is actually a little bit different, because health economics as a discipline is not so widely used or understood. We don’t have a large payer society, so the customers that we often discuss health economics data with are actually physicians. That makes the commercial part even more important because they might not have a good understanding of a QALY or an ICER for example. You have to be very clear and simple in your messaging.

How has BaseCase been used at your company?

We started using BaseCase in August, so we are just about to finalize the first model in BaseCase and that will be an external model that our sales reps will use in hospital visits. They can plug in local numbers and get a saving for the department out of the model.

This is a purely external instrument, but we have thought about also developing a tool for internal use, especially around the treatment cost of different treatment regimes, because often when people talk about treatment costs they talk about different levels of prices – Pharmacy Purchasing Prices, Pharmacy Selling Prices etc. – so internally it can be very confusing. We thought about building some kind of a model, a simple tool, so we always have a clear model with the right prices.

Do you think pharmaceutical companies and technology applications fit together well?

I think it’s a natural fit, I think though that it’s getting more and more complicated in terms of legal issues. First of all, we can’t really go out with anything that is not published, and in Denmark, a poster is not enough, it needs to be peer-reviewed. This creates a limitation, because often when you want to build a budget impact type of model, you don’t have all the evidence published yet.