ISPOR Conference “HEOR: A Transformative Force for Whole Health” Atlanta, 2024

The ISPOR 2024 conference in Atlanta is themed “HEOR: A Transformative Force for Whole Health”. Will this advocated, holistic approach to HEOR, which is conceptually not new, be reflected in future drug pricing?

In strategic forecasting, pricing and market access are key parameters. The Inflation Reduction Act has dominated the headlines on this topic since its introduction to the US in 2022. However, without much detail on its impact on net price being known yet, what can be learned from the initial negotiations?

No conference is without AI nowadays. What is the role of generative AI in Health HEOR and RWE? And, of course, Real World Data (RWD) and data analysis remain evergreen topics at ISPOR.

Key Takeaways

  • The benefits of a holistic approach to health are well accepted but value beyond the patient has yet to significantly and directly impact pricing and reimbursement decisions
  • The complexity emerging in IRA’s price-setting process was highlighted as CMS prepares for another round of negotiations
  • As generative AI continues to evolve, hurdles still have to be overcome before its transformative benefits can be realised
  • Integrating diverse RWD sources to create dependable and ethical evidence demands the overcoming of challenges in data accuracy, reliability and stakeholder communication

What we won’t forget from the conference

  • The IRA negotiation process and its likely outcome for manufacturers remains uncertain for now on many levels. However, for long term forecasting, a high-level, rule-of-thumb discount is needed for your forecast. groupH proposes to use an average rate of ~30% for the Medicare insured share of target patients from the year the IRA rebate might kick in onwards
  • RWD and HEOR remain evergreen topics. Important but only indirectly supporting key forecast assumptions
  • AI has also made its way to ISPOR. Its multitude of possible uses promise long term opportunity and transformation, but high validation and educational hurdles prevent any short term impact in market access or pricing & reimbursement
  • We note the continued, holistic approach to health that ISPOR has been advocating this year was expressed by numerous sessions focused on patient-centredness in research and decision making. But we also continue to watch how this approach will exactly
    translate to pricing negotiations in the long term

Please follow the link to a more detailed summary: EVENT SUMMARY

Summary is for long term forecasting specialists and strategic market access.

By Erik Holzinger, groupH, London and Keshalini Sabaratnam, London


Event Summary “German Chapter Meeting” Berlin, April 2024

We are almost one year on from ephmra’s 2023 annual conference when we were told that in the future, on average, AI will free up 37% of our time. For many this was a wake-up call at the time but one year later in Berlin, there is still a sentiment that it cannot yet be foreseen how exactly AI is going to change future market research and insight work. There are still relatively few pharma case studies around and overall AI literacy is only just emerging, similar to AI being as novel as a new molecule in Phase 1.

The ephmra German Chapter meeting was looking to provide not only more food-for-thought but also hands-on AI experience and perhaps a reminder that innovation is not all about AI.

Here is groupH’s pick of the key messages.

AI is not perfect but engage rather than wait

Paul Simmering from Team Q gave some background on the history of AI, its progress in recent years, its key principles and illustrated ways of how to customize AI for more relevant responses. In his view, the promise of AI lies in its ability to offer a bigger scale of analysis while also allowing more time for big-picture strategy, communication and action. QC measures, however, remain to be optimised to address potential issues with LLMs. These challenges include potentially imprecise, incomplete, obsolete, not-reproduceable or hallucinating responses, which may undermine trust in the technology.

Acquiring AI literacy includes refining prompt engineering skills

Guided hands-on AI training sessions helped to create synthetic respondents and AI images. We also used AI for the coding of open-ended questions and learned how to use the right prompts to find, extract and condense publicly available information with ChatGPT for a case study. In this example case study extracting and comparing existing or planned use of AI and other new technologies between the 2023 annual reports of Pfizer and AstraZeneca was possible in less than 2 minutes even for a less experienced AI user.

Traditional research formats such as ATUs are evolving

While popular and seen as indispensable, traditional message recall projects may suffer from shortcomings such as lack of actionability of outputs or potential inflation of ‘true’ impact while they are resource intensive and time consuming. Samy Issaoui from Instar suggests that more value can be generated with a more holistic approach involving customisable master KPI modules, expanded recall timeframes, use of chatbots and real-time dashboards.

What we won’t forget from the conference

  • Demystifying AI is much less daunting when organised as a series of informal workshops
  • There is another angle when looking at AI, not as a rising tide of new AI enabled tools but as a range of possibilities that may enhance or complement a given use-case
  • It is still early days for AI. Similar to a Phase 1, FIH drug trial, the milestone generates excitement but still carries a lot of uncertainty. Generative AI LLMs mimic human responses but unlike humans they do not [yet] have an internal view of the world and hence may lack the important attribute of reproducibility
  • Loft workspaces are nice but do come at the cost of climbing at least 5 flights of stairs in the typical Berlin early 20th century houses

By Erik Holzinger, groupH, London


Seasons Greetings 2023

Unlike 2022, luckily our Christmas lunch gathering has not been affected by any train or air travel strike action this year.  So some of the people who make up groupH in Europe came together at the Zetter Townhouse for a couple of hours. Special thanks to our cello player Garwin Lynnell for not only a rendition of Bach but also of Kraftwerk – very special indeed.

We will be off to a short break and look forward to serve you again in 2024.

The groupH team

Happy Holidays from the groupH team

Dear clients and colleagues,

As another year draws to a close, it is not only friends, colleagues and family who have been sitting at work and dinner tables this year, but also a new visitor called AI. We hope you like the illustration on our Christmas card and that meeting AI is the ‘beginning of a beautiful friendship’ as in ‘Casablanca’, rather than the fate of HAL9000 in 2001: A Space Odyssey, who faced deactivation in the end.

I leave you with a quote from the physicist Richard P. Feynman “I can live with doubt and uncertainty and not knowing. I think it is much more interesting to live not knowing than to have answers that might be wrong.”

Thank you to all our clients, collaborators, associates and friends and to all their families who supported us whilst we delivered on our work commitments throughout the year. Thanks to Yasmin El-Saie, our resident artist for the drawing (

The groupH Team

End-of-Summer 2023

On Friday 15th September, the groupH core team and local associates met in London for an end-of-summer social get together. At our dinner in Notting Hill, we celebrated togetherness, successfully completed projects, catching up on personal news and the fact that luck was on our side with glorious late-summer weather throughout the day.


Join groupH’s discussion on TPP Development and Indication Prioritization at the NPP Summit Boston

groupH will talk through 2 project case studies focusing on TPP Development and Indication Prioritization for Biotech companies at pre-clinical or early-stage clinical stage. The talk is aimed at individuals in commercial and non-commercial roles who have to manage uncertainty when aligning on overall scientific and commercial strategy. We will discuss a recent, real-world project process and the trade-offs between different, alternative project approaches. We will dissect the TPP development process and share client views on project timing and project learnings. Participants will leave with key insights from this real-world technology platform development project and there will be time for Q&A at the end.

About Erik Holzinger, groupH:

Erik Holzinger MBA is the founder of groupH a Consulting company dedicated to commercial decision making and analysis. In recent years Erik has been particularly interested in exploring the topics driving TPP development at the more delicate, early stages when commercial and scientific uncertainty is still quite high. Erik is also active as member of the ephmra Annual Conference Organising Committee and co-founder of the ephmra Forecasting Forum. Prior to 2005, he was a Principal Consultant in the Pharmaceuticals and Biotechnology team of Wood Mackenzie and a Consultant at The Wilkerson Group. His mother tongue is German, and he is fluent in English and Spanish and lives in South-West London with his family. Outside of work Erik enjoys spending time with his family, yoga, cycling, windsurfing, skiing and the cultural landscape of London.

Find out more about the NPP Summit Boston, October 16, 2023:

Register for the event:

See full list of speakers:

View full programme:

Any questions just get in touch –

The groupH Team

Event Summary “Using AI to Power Insights and the Business” Basel, September 2023




The one-day meeting in Basel on “Using AI to Power Insights and the Business” had been much anticipated.  It allowed us to deep-dive into the topic of AI in a more intimate setting following the discussions from the conference in June. AI in drug development seems almost like news from yesterday, but AI in business insight so far had less headline space. Can AI bring more than efficiencies? Can AI even help to find your killer insight?

Here is groupH’s pick of the key messages.

AI, for now, is “just another ‘person’ at the table”

To cut a long story short: there is much potential for AI as an assistant for specific uses but, generally, while it still has its flaws, the majority of presenters strike a somewhat cautionary note not to over rely on AI at this point.

The fact that AI (only) mimics human behaviour, is being trained for plausibility and not for truth, occasionally makes things up and is unable to explain exactly how it functions and where its information is coming from does not make a case for giving AI a senior role at the table. It would not for any human with the same traits.

AI is not yet ready – the audience is not yet ready

There is widespread experimentation with AI.  In the main, individuals are using their personal versus their company logins and industry can only count a small number of experts. Perhaps the phase of ‘shock’ has passed, but before AI is being accepted as the new normal there is a phase of ongoing reorientation.

In Social Media Listening (SML), for example, AI is being trained to be more subtle and nuanced.  However, it is not yet ready to frame a narrative within the context of research, opportunities and threats as Stephan Lebrat, Global MR Director at Takeda points out. And English language models currently dominate over other languages.

DALL-E 3 has just been made available by OpenAI as a generative visual art platform that integrates with ChatGPT and is meant to understand context better than its predecessor.

A glimpse into the future of AI for agencies and industry?

Current AI language models make it possible to create artificial respondents whose responses to questions are difficult to keep apart from real respondents as Gemma McConnell from Day One Strategy explains. These AI respondents may be able to help with gaining an initial understanding of healthcare environments across therapy areas and indications at a much lower cost and much faster than undertaking PMR. This may be particularly helpful in conducting mock interviews preceding patient research; it may be particularly useful in rare diseases, where PMR is generally more challenging. At the moment, however, ChatGPT patient responses have a more generic feel to them and it is not known on which data they are based.

AI assisted desk research and first pass analysis of text, recordings and images helps agencies to become more efficient. An example of how AI is being used today for coding of data (e.g. for open ended questions) is the text analysis tool Caplena, Researcher time spent with coding has been reduced by 46 – 67% according to Stephen Potts from Purdie Pascoe in a case study describing the adoption and implementation process.

Industry may be able to find a new purpose for existing data sets that support internal hypotheses generation but wants to make sure that its data is not training external models.

The personality profile of bots is typically highly agreeable and low in neuroticism as Paula Coyle from Blueprint Partnership explains. This may have an application in QC of demand forecast survey responses. In a self-funded study, the Mini-IPIP was used as a validated tool to segment physicians into under-, over- and accurate-estimators of their own prescribing. In the future it is thinkable that AI combined with behavioural science tools may allow to offer a more elegant and accurate calibration approach compared to traditional blanket calibration.

Fenna Gloggner from Idorsia Pharmaceuticals explained how Idorsia built its own internal ChatGPT model, an example also described by Ana Maria Aguirre Arteta, Global Governance Director at Novartis.

What we won’t forget from the conference

  • Can AI bring currently more than efficiencies to business insight? No. Not really. But in large, data-heavy studies AI may become routinely used in the mid- to long-term, under the watchful eye of human intelligence (HI).
  • Can AI help to find your killer insight? No. Not directly. But it may support making hypothesis and help analysis through consistent coding of transcripts.
  • Gemma McConnell’s synthetic patient animation – close to indistinguishable from the real patient. Offering the mining of existing data repositories to supplement research with real patients.
  • How will industry benefit from AI? Presented case studies describing efficiency gains far outweigh those hinting at insight quality gains from AI. Overall project value delivered by an agency remains driven mainly by HI for the foreseeable future.
  • It may be too early at this point to count on efficiencies offered by AI before the technology is fully trusted by all stakeholders, However, over time these efficiencies are likely to materialise and may spur some competition among agencies to pass on some of these efficiency gains.
  • The sigh of relief that ~80% of doctors were found being able to accurately estimate their own level of prescribing for a known product for the week after the question was asked (!) as Paula Coyle from Blueprint Partnership explained.

By Erik Holzinger, groupH, London


Event report 2023 ephmra Annual Conference

The three-day ephmra annual conference in London featured a line-up of 24 presentations, panel discussions and roundtables, with 200 delegates from industry and agencies. Compared to previous years, we observed an increase in industry delegate participation and an overall younger audience – both positive developments. After three years of online conferences, the joy of face-to-face interaction was very palpable. Here is groupH’s pick of 2023’s key messages.

37% time-saving through Artificial Intelligence

The discussion can be summed up by the phrase: “you’d better embrace AI before it embraces you!” While the jury is still out identifying where exactly AI will be able to play to its strengths, the majority of speakers and audiences anticipate that our jobs as we know them will be  ’consigned to Room 101’. The promise is that AI will help in a positive way to reduce time spent on more mundane tasks while freeing up more time for more creative and value-adding activities. However, even the most optimistic advocates did admit that there is still a large amount of uncertainty and that some scepticism and caution is warranted around potential AI drawbacks or pitfalls in this Brave New World.

We heard phrases such as “Revolution with Responsibility” and “Not walking away with fear” during the discussion on AI, which is understandable as topics such as “synthetic data” and “synthetic respondents” have been discussed. While ChatGPT attracts billions of hits, pharma companies protect their corporate network through firewalls. This shows that the question how private, public and corporate use of AI will be managed is still in the process of being answered. AI has a large carbon footprint, is said to be heavily subsidised at the moment (a platform costs $80-100m to be set up), consumes & generates a lot of electricity & heat, and ‘only’ has currently ~100m users. The example of AI, until recently at least, being biased towards giving a reasonable-sounding answer almost to any question, whether the question made sense or not, raises eyebrows.

But ask your AI the infamous question of the difference between cow eggs and chicken eggs and you will notice that it is now further up the learning curve.

As long as AI struggles with complex questions, remains a black-box and is unable to explain the ‘Why?’ behind an answer, and as long as the audience remains aware and critical about its shortcomings, we are not too worried that it could replace market researchers and industry consultants any time soon instead it is likely that it will change the way we all work.

Looking for the killer insight for your launch

Geoff Birkett’s keynote talk on successful launches and a Novartis case study on generating patient insights brought home once more the importance of understanding one’s market and the needs of its patients as a key ingredient for remaining competitive. Market research and business intelligence remain indispensable in generating these killer insights that will differentiate your product. But we also learned that it is not just about the data and its analysis. There are some more intangible factors at play that make the difference between an average, a good and a great product launch. These factors rely on how the launch team is made up, its ethos and, above all, Human and not Artificial Intelligence. Geoff Birkett’s launches worked well in teams who put the Team first, the Organisation second and the Individual third.

No return to pre-pandemic travel

Despite the post-pandemic joy of being able to meet in-person again and general agreement that this offers a much higher quality of interaction and communication, no-one saw a return to pre-pandemic levels of inter-company travel, face-to-face interviews or central location primary research. Whether we like it or not, Zoom, Teams and hybrid-working are here to stay because it maintains or increases productivity and offers more flexibility, while at the same time saves on time and budget.

On the other hand, excellence seems to happen in the form of sharp and insightful outputs and team-building takes place when individuals come together in person and cross functionally in a fun setting. That’s why the 3-days-in-the-office rule that seems popular now won’t go away too soon.

No one suggested though that embracing Mark Zuckerberg’s Metaverse in the same way as AI is necessary at this point. It seems that this question, for now at least, does not yet pose itself.

Behavioural Science

Measuring attitudes and understanding behaviours and anticipating the impact of new  treatments on all stakeholders involved in delivering healthcare remains crucial. Hence the discipline of Behavioural Science continues to evolve. As millennial doctors become the majority of the workforce, their needs, attitudes and beliefs will shape future communications. Communication strategies will need to adapt and change from a Push to a Pull philosophy in the process.

Behavioural Science in Forecasting

The ephmra Forecasting Roundtable discussed the potential benefit Behavioural Science can offer in future forecasting projects. Can the COM-B model help to better anticipate physician prescribing behaviour and calibrate preference shares? The audience thought that the COM-B model such as information on the drivers of behaviour change (capability, motivation and opportunity) could be included in questionnaires and help to offer qualitative insights on the potential barriers to or enablers of prescribing and the speed of uptake. Over time, enough data may be collected to also allow the quantitative calibration of a model but this is not anticipated for the very short term.

Target Product Profiles for Primary Market Research

This topic was discussed as part of the Forecasting and Data Analytics Roundtable and distilled the experiences of presenters and audience members into a few, easy-to-remember steps and useful tips on how to avoid common pitfalls. The key elements include:

  • Alignment on data and edits with all stakeholders inside agency and client organisations
  • An easy-to-read visual format
  • Appropriateness of the amount of information presented
  • (Perhaps the most important criteria) The imperative to understand and refer to the existing [and perhaps future] clinical and commercial standard-of-care/comparator when drafting the TPP and talking to doctors and payers.

Most tips apply to both qualitative and quantitative PMR, with quantitative assessments requiring additional alignment on the structure and number of attributes listed.

What we won’t forget from the conference

  • Rachel Lawes’ talk on semiotics in menopause was one of the most entertaining and educational [there will be a video made available by ephmra soon, we understand]
  • Narrow staircases and smaller rooms in old buildings may be just what is needed for a good conference as they prevent anyone getting lost!
  • Last, not least, even a fire drill on the third day could not dent the good spirit of presenters and attendees

By Erik Holzinger, groupH, London


Happy Holidays from the groupH team

Dear clients and colleagues,

As before this year’s budget that used to be for physical Christmas mailings to three selected organisations who do incredible work throughout the year in different areas. They were not chosen for their size but for how close we feel to their cause, how they are run, how well we know the people who run them and the difference they make for the people they support locally.

We would like to help raising their profile. So please check them out and help supporting them if you can: AZAHAR FoundationLisa’s GiftSporting Star. We thank you for your trust in us and look forward to hopefully supporting you again during 2023.

The groupH Team

2022 : groupH remains carbon neutral

Since its inception in 2005 the virtual working model of groupH has meant our impact on the planet, due to emissions, has always been minimal. Employees only travel for essential business and home-office working erases the need for a daily commute or a separate building infrastructure with its inherent energy needs.

In 2022 we are continuing to offset our 40t of annual carbon output. This year we are supporting the DelAgua Public Health Program in Eastern Africa. This project has been running since 2012, in partnership with the Government of Rwanda, providing free, innovative, high performance stoves. Over 3 billion people still cook over polluting fires, a major contributor to carbon emissions. Household air pollution is the leading environmental cause of death and disability, ahead of unsafe water and lack of sanitation, causing more deaths than Malaria, HIV and TB combined. Clean cookstoves are vital to tackle both global challenges.

The groupH effect on the global climate will thus remain neutral moving forward. View our certificate here.

Through this initiative groupH continue to send a clear message that we have a desire to work together to build a more sustainable and better world for our colleagues, clients and the global community.