Nermina Ferizovic | Health Economics Expert

‘What is in a name?’ was posed by William Shakespeare in Romeo and Juliet and in terms of health economics and outcomes research (HEOR) is a very valid question which should be considered carefully. The first step in these considerations is an assessment of the definition and aims of HEOR. 

Currently, there is no set definition for HEOR but, for the sake of argument, it can be considered as a sum of its part. Firstly, health economics, which is defined as the study of economics as applied to health i.e., the determination of the most appropriate resource allocation in health. On the other hand, outcomes research has multiple competing definitions. The Academy of Managed Care Pharmacy (AMCP) splits outcomes research into three elements: pharmacoeconomics, comparative effectiveness research and humanistic considerations, namely health-related quality-of-life (1). An alternative definition is “the entire evaluation of health professionals’ efforts in ameliorating patients’ health conditions” (2). A final definition put forth is “health outcomes studies help determine what works and what doesn’t in healthcare” (3). As such, it seems that the definition of outcomes research can be described as non-defined.

In terms of these definitions, the second and third are similar in that they imply that outcomes research aims at determining the impact an intervention has on population health, with impact specifically referring to health impact i.e., what are the consequences of a health intervention on the health of a population or an individual? However, the second definition is focussed on healthcare professionals’ actions solely with a broader outlook considered in the third inferring that ‘outcomes’ in health can be reached through diverse actions. Finally, the first definition provided by the AMCP is very interesting. This definition is rather different to the other two due to its primary focus on pharmaceuticals and the interesting inclusion of pharmacoeconomics, a recognised branch of health economics, in its definition. 

A consensus on the definition of outcomes research may be warranted. However, the overarching theme, give or take the presented inconsistencies, of all the definitions presented here is that health outcomes research is aimed at assessing the impact of interventions, which can be delivered by multiple means, on individuals and populations, with a key aim of being able to measure the impact of these interventions. Is this reason enough for health economics to be considered a spouse of outcomes research, or vice versa as suggested by “HEOR”? 

Albeit it is difficult to deliver a firm conclusion given the lack of consensus of a definition, but the question could be, therefore, do the overarching themes of these definitions ‘fit’ with the agreed definition of health economics whose aim it is to inform resource allocation in health? Indeed, it can certainly be argued that the output of outcomes research can, and does, inform resource allocation decisions. But is this not the case with many other areas of research? 

1. Academy of Managed Care Pharmacy (AMCP). What is outcomes research: https://www.amcp.org/about/managed-care-pharmacy-101/concepts-managed-care-pharmacy/outcomes-research. Accessed: August 2021

2. Encyclopaedia of Behavioural Medicine. Health Outcomes Research. 2013 Edition. Editors: Marc D. Gellman and J Rick Turner

3. Using Health Outcomes Research to Improve Quality of Care: https://www.hsph.harvard.edu/ecpe/using-health-outcomes-research-to-improve-quality-of-care/. Accessed: August 2021.