Health economics and outcomes research (HEOR) services

01Overview and value chain#

Markers EC: Health-economics evidence generation & HTA dossier services | OECD: Bioeconomy policy & governance | Regulator: none — private research and consulting practice, not a licensed regulatory function

Health economics and outcomes research (HEOR) as a B2B service is a category in which specialist research organizations build the economic and clinical-outcomes evidence pharmaceutical and biotech companies need to justify a product’s value to payers and health-technology-assessment (HTA) bodies, work increasingly pulled earlier into the development timeline. RTI Health Solutions is a globally recognized research organization dedicated to improving healthcare decisions through evidence generation, with 2026 industry surveys noting HEOR’s growing influence on trial design and value strategy even as resources remain constrained. Evidera (part of PPD/Thermo Fisher Scientific) demonstrates a product’s economic value through advanced modeling and evidence synthesis, and is actively applying AI and real-world data to strengthen evidence generation across the therapy lifecycle. OPEN Health runs a dedicated HEOR and market-access practice, presenting research at ISPOR 2026 alongside the field’s other major players. PRECISIONheor contributes to the field’s methodological debate, including work on structuring payer-tradeoff analysis ahead of market-access decisions. Cytel applies AI to HEOR through case studies navigating regulatory and HTA guidance, alongside its established biostatistics practice, and analyzes how US drug-pricing reform could affect pharma HEOR evidence generation. ICON plc, a clinical research organization providing outsourced clinical development and commercialization services, runs a global health-economics, outcomes-research and epidemiology team supporting drug reimbursement and market-access strategy.

The key directions of HEOR B2B services are:

Cost-effectiveness and economic modeling: building the quantitative models that demonstrate a product’s economic value relative to existing standards of care.
Real-world evidence (RWE) synthesis: generating and synthesizing evidence from real-world clinical practice to complement randomized-trial data for payer and HTA submissions.
HTA dossier development: preparing the specific evidence dossiers required by health-technology-assessment bodies to support a reimbursement or coverage decision.
AI-assisted evidence generation: applying AI and real-world data analytics to accelerate and strengthen evidence generation across the drug-development and commercialization lifecycle.

Sectoral value chain#

[Evidence-strategy planning] ──> [Economic model & RWE study design] ──> [Data collection & evidence synthesis]
                                                                    │
                                                        (HTA/payer requirement mapping)
                                                                    │
              [Post-submission evidence updates] <──── [HTA/payer decision outcome] <─── [Dossier submission]

Fig. 1— Sectoral value chain

Value chain levels#

Level	Description	Key inputs/outputs
Evidence-strategy planning	Determining the economic and outcomes evidence a product will need for its target markets’ payers and HTA bodies.	In: Clinical development plan, target-market list. Out: Evidence-generation strategy.
Study design	Designing the economic models and real-world-evidence studies specified by the evidence strategy.	In: Evidence-generation strategy. Out: Study protocols and model designs.
Data collection and synthesis	Collecting clinical, economic and real-world data and synthesizing it into a coherent evidence base.	In: Study protocols, clinical/RWE data sources. Out: Synthesized evidence base.
Dossier submission	Compiling the evidence base into the specific dossier format required by a target HTA body or payer.	In: Synthesized evidence base, HTA/payer requirements. Out: Submitted HTA/payer dossier.
HTA/payer decision outcome	The HTA body or payer reviews the dossier and issues a coverage or reimbursement decision.	In: Submitted dossier. Out: Coverage/reimbursement decision.
Post-submission evidence updates	Generating additional evidence to support ongoing coverage, respond to payer queries, or support a renewal or appeal.	In: Coverage/reimbursement decision. Out: Updated evidence supporting ongoing access.

Table 1— Value chain levels

Cross-cutting technologies of the sector:

Real-world-evidence modeling: economic and outcomes models built on real-world clinical-practice data rather than randomized-trial data alone.
HTA dossier development: the specific practice of assembling evidence into the format and structure required by a given health-technology-assessment body.
AI-assisted evidence synthesis: applying AI and real-world data analytics to accelerate evidence generation and synthesis across the HEOR workflow.

02US#

The United States hosts the largest concentration of dedicated HEOR research organizations, several combining decades of health-economics methodology with newly emerging AI-assisted evidence-generation practices.

RTI Health Solutions: a globally recognized research organization dedicated to improving healthcare decisions through evidence generation, with HEOR’s role expanding earlier into trial design and value strategy even as resources remain constrained.
Evidera (PPD/Thermo Fisher Scientific): demonstrates a product’s economic value through advanced modeling and evidence synthesis, actively applying AI and real-world data to strengthen evidence generation across the therapy lifecycle.
PRECISIONheor: contributes to the field’s methodological debate, including work on structuring payer-tradeoff analysis ahead of market-access decisions.
Cytel: applies AI to HEOR through case studies navigating regulatory and HTA guidance, alongside its established biostatistics practice, and analyzes potential impacts of US drug-pricing reform on pharma HEOR evidence generation.

03CN#

China is covered qualitatively rather than through a live-screened Chinese vendor: candidate Chinese HEOR consultancies searched during this screen returned no confirming 2026 source, so no Chinese company is tabled below. Chinese pharmaceutical developers seeking HTA and reimbursement evidence, including for the country’s own National Reimbursement Drug List process, typically work with the global HEOR firms listed here or with domestic health-economics research institutes whose specific commercial consulting practices could not be confirmed in this screen.

China’s HTA and reimbursement-list evidence needs served without a confirmed domestic specialist#

Global-firm engagement pattern: Chinese pharmaceutical developers pursuing National Reimbursement Drug List inclusion or international market access typically engage the global HEOR firms listed in this article.
Domestic gap: no Chinese-headquartered HEOR consultancy confirmed by a live 2026 source was found during this screen.

04EU#

Europe hosts specialist market-access and HEOR practices operating across the continent’s fragmented national health-technology-assessment systems.

OPEN Health’s dedicated HEOR and market-access practice, ICON plc’s global health-economics and epidemiology team#

OPEN Health: runs a dedicated HEOR and market-access practice, presenting research at ISPOR 2026 alongside the field’s other major players.
ICON plc: a clinical research organization providing outsourced clinical development and commercialization services, runs a global health-economics, outcomes-research and epidemiology team supporting drug reimbursement and market-access strategy.

05Leading companies and research institutes#

Company / Institute	Country	Key products / platforms	Tech features	Status 2026
RTI Health Solutions	🇺🇸 USA	Evidence-generation research	Growing HEOR influence on trial design	commercial
Evidera (PPD)	🇺🇸 USA	Economic modeling & evidence synthesis	AI and real-world-data-driven modeling	commercial
OPEN Health	🇬🇧 United Kingdom	HEOR & market-access practice	Active ISPOR research presence	commercial
PRECISIONheor	🇺🇸 USA	Payer-tradeoff methodology research	Contributes to HEOR methods debate	commercial
Cytel	🇺🇸 USA	AI-assisted HEOR & biostatistics	HTA/regulatory guidance navigation	commercial
ICON plc HEOR	🇮🇪 Ireland	Global HEOR & epidemiology team	Reimbursement/market-access strategy support	commercial

Table 2— Leading companies and research institutes

06Tech stack and innovations#

The HEOR B2B services technology stack combines established health-economics methodology with an emerging layer of AI-assisted evidence generation:

Real-world-evidence modeling:
- Firms such as Evidera build economic and outcomes models on real-world clinical-practice data, complementing randomized-trial evidence for payer and HTA submissions.
AI-assisted evidence synthesis:
- Cytel and Evidera apply AI and real-world data analytics to accelerate evidence generation and navigate regulatory and HTA guidance more efficiently.
HTA dossier development:
- OPEN Health and ICON plc assemble evidence into the specific format and structure required by target health-technology-assessment bodies, supporting reimbursement decisions across multiple jurisdictions.

07Value chains and production pipelines#

Industrial pipeline for a HEOR evidence-generation engagement#

┌───────────────────────────┐      ┌───────────────────────────┐
│ 1. Evidence-strategy        │ ───> │ 2. Study design              │
│    planning                     │      │                                   │
└───────────────────────────┘      └───────────────────────────┘
                                                 │
                                                 ▼
┌───────────────────────────┐      ┌───────────────────────────┐
│ 4. Dossier submission       │ <─── │ 3. Data collection &        │
│                                  │      │    synthesis                     │
└───────────────────────────┘      └───────────────────────────┘
              │
              ▼
┌───────────────────────────┐      ┌───────────────────────────┐
│ 5. HTA/payer decision       │ ───> │ 6. Post-submission          │
│    outcome                      │      │    evidence updates              │
└───────────────────────────┘      └───────────────────────────┘

Fig. 2— Industrial pipeline for a HEOR evidence-generation engagement

Stage 1: Evidence-strategy planning

The HEOR firm determines the economic and outcomes evidence a product will need for its target markets’ payers and HTA bodies.

Stage 2: Study design

Economic models and real-world-evidence studies are designed to generate the specific evidence the strategy calls for.

Stage 3: Data collection and synthesis

Clinical, economic and real-world data are collected and synthesized into a coherent evidence base supporting the product’s value claims.

Stage 4: Dossier submission

The synthesized evidence base is compiled into the specific dossier format required by a target HTA body or payer and submitted.

Stage 5: HTA/payer decision outcome

The HTA body or payer reviews the dossier and issues a coverage or reimbursement decision, sometimes requesting additional evidence first.

Stage 6: Post-submission evidence updates

The HEOR firm generates additional evidence to support ongoing coverage, respond to payer queries, or support a renewal or appeal of the original decision.

Supplier	Region & tags
RTI Health Solutions	US
Evidera (PPD)	US
OPEN Health	EU
PRECISIONheor	US
Cytel	US
ICON plc	EU

AI Recommendation

Key directions:

Cost-effectiveness and economic modeling — building the quantitative models that demonstrate a product’s economic value relative to existing standards of care.
Real-world evidence (RWE) synthesis — generating and synthesizing evidence from real-world clinical practice to complement randomized-trial data for payer and HTA submissions.
HTA dossier development — preparing the specific evidence dossiers required by health-technology-assessment bodies to support a reimbursement or coverage decision.
AI-assisted evidence generation — applying AI and real-world data analytics to accelerate and strengthen evidence generation across the development lifecycle.

Regulatory:

There is no regulator or licensing body governing HEOR itself — this is a private research and consulting practice, but its output feeds directly into HTA and payer decisions that are themselves regulated processes.
HTA bodies in different countries (e.g. NICE in the UK, IQWiG in Germany) apply distinct evidence standards, so a dossier built for one jurisdiction often cannot be reused unchanged in another.
HEOR work is increasingly required earlier in clinical development rather than after approval, since trial design itself now needs to anticipate the evidence a payer will eventually demand.

Companies not in table: no confirmed candidate was dropped in this screen — the six-row table filled exactly from the confirmed set (four US, two EU); China’s National Reimbursement Drug List evidence needs are described qualitatively since no Chinese HEOR consultancy confirmed by a live source.

Category boundary: this is distinct from general market-access or regulatory-submission consulting — HEOR’s specific deliverable is the economic and outcomes evidence itself (models, RWE studies, HTA dossiers), which market-access firms then use as an input to their broader reimbursement strategy work.

Processing note: several firms in this table (Evidera, Cytel) explicitly describe applying AI to their HEOR workflow in 2026, a methodological shift from the field’s historically manual evidence-synthesis process.