Marco HEOR enables payers and insurers to evaluate clinical and economic evidence for covered or coverage-pending health technologies in a structured and transparent way. It facilitates evidence-based coverage decisions and the defense of those decisions before regulators and patients.
Some answers to questions we often receive
Yes. Marco HEOR includes budget impact analysis modules that allow projecting the coverage cost of a health technology for the company's policyholder portfolio.
Yes. Marco HEOR enables comparative effectiveness analyses between different therapeutic alternatives for the same indication, facilitating coverage decisions based on the best available therapeutic value.
Marco HEOR recommends periodic re-evaluations —annual or biannual— incorporating new real-world evidence and guideline updates that may modify the therapeutic value or cost-effectiveness analysis of the covered treatment.
Yes. Marco HEOR generates full traceability of the evaluation process: sources consulted, criteria applied, and conclusions, allowing the payer to demonstrate the rigor of its coverage decisions before regulators.
Yes. Marco HEOR structures the evidence needed to design and negotiate outcomes-based risk-sharing agreements (MEAs), allowing payers to access innovative treatments with payment schemes tied to real-world clinical effectiveness.
Yes. Marco HEOR can incorporate internal claims and utilization data to contrast them against published real-world data, generating gap analyses that inform coverage management decisions.
Payers need to rigorously evaluate whether a high-cost oncology treatment should be covered, but don't always have structured tools to do so efficiently and in an auditable way.
