HEOR stands for Health Economics and Outcomes Research. It sounds like academic jargon, but it answers the most practical question of all — the one a payer asks before covering any technology: what do I get, and what does it cost me?
A company that can't answer that with defensible numbers has a product, not an access case.
The payer's two questions
Every payer — public system or insurer — evaluates a new technology through two different lenses, and you need to answer both:
| Question | What it measures | Tool |
|---|---|---|
| Is it worth what it costs? | The cost per outcome gained versus the current alternative | Cost-effectiveness analysis |
| What does it cost me this year? | The total effect on the budget of adopting it across the population | Budget-impact analysis |
They're different and both decide. A technology can be highly cost-effective over the long run and still be rejected because its year-one budget impact doesn't fit. Presenting only one of the two is the most common cause of a no.
You can't copy another country's dossier
Costs, the prices of alternatives, epidemiology, and the way care is organized all change from one country to the next. A cost-effectiveness model built for the United States or Europe won't convince a Mexican or Colombian payer: the assumptions aren't theirs. Real-world evidence (RWE) and local cost data are what hold the argument up.
Rule of thumbThe value dossier is designed before you run the studies, not after. If you define the outcomes to measure once the trial is done, you'll almost always be missing exactly the data the payer asks for.
The Latin American context
The region doesn't assess uniformly. Mexico has bodies such as CENETEC for health technology assessment, and access to the public sector runs through formal inclusion processes into purchasing formularies. Other countries have their own agencies and criteria. That heterogeneity means there is no single value argument for all of LatAm: there's a common evidence base and several local adaptations.
When to start and what it connects to
Early. HEOR questions should shape evidence design from the outset, so the studies measure what the payer will ask. And it doesn't live in isolation: it leans on Medical Affairs for the clinical read and on the regulatory and market-access strategy to turn the value argument into real coverage. It's ecosystem work — the way we approach the health vertical at Linkr.