#MedCommsDay 2023
Meet Eleanor Bush
Eleanor Bush is a Health Economics and Outcomes Research (HEOR) Writer located in the US. Eleanor has been at OPEN Health for about 1.5 years. She had worked in agencies before as a freelancer, but she was drawn to OPEN Health because of the commitment and investment in HEOR as its own “thing” rather than a side project
An interview with Eleanor Bush, HEOR Writer
In this interview, Eleanor discusses the unique nature of HEOR writing, the evolving landscape it addresses, the role of persuasion in conveying contextual importance, the motivation and excitement behind pursuing HEOR as a career, and the pride in patient-centered work.
How does HEOR writing differ from traditional medical writing?
I still write publications, but the focus is different. While a traditional medical writer is communicating the facts about a specific medication, like mechanism of action and efficacy of treatment, HEOR is about communicating the context surrounding the medication. We are talking about the landscape that a new medication is entering, in terms of how it compares to its competitors and what unmet needs remain for patients.
That landscape evolves over time — sometimes radically. HEOR is still scientific, and still approached in a rigorous, replicable way, but what we are describing in our research is always changing. At the technical end of the spectrum, we use a number of techniques like network meta-analyses and matching-adjusted indirect comparisons of clinical trial data. But we also investigate the reality of clinical practice versus guidelines, or areas of health inequality; we may use qualitative research that articulates needs or preferences that quantitative data cannot always capture.
Would you say there is also an element of persuasion in HEOR that doesn’t come into traditional medical writing?
With a standard clinical trial publication, you are trying to convince your reader that your experimental methods can withstand scrutiny and your results are valid. HEOR takes the next step forward. We are saying, “Not only are these results valid, they are important — and here’s why.” Payers, clinicians, and patients need more than just efficacy data to come to an informed decision. When you consider all the surrounding context, economic burden, quality of life, and other patient-reported outcomes can sometimes matter just as much.
Take adherence as an example. There are so many reasons people find they cannot stick to a medication they have been prescribed. Maybe it has intolerable side effects, maybe they would prefer a pill over an injection, or maybe they would prefer instant symptomatic relief even if it does not last as long. If you dig a little deeper, you might find that a new medication that seems more expensive is actually more cost effective over time, because patients can fit it into their lives more easily.
What motivated you to pursue HEOR as a career, and what keeps you excited and engaged?
HEOR is fascinating to me because there is a panoply of approaches you can take to solve a multiplex problem. New methodologies are always being developed as well, which I love. I feel very at home swimming in that sea.
What are you most proud of in your career so far?
That is difficult to answer because I don’t think it is any one project. Where I'm able to center the patient, with the ultimate goal of improving their access to treatment, that's what I'm most proud of.
Finally, what do you think is the key to a long, successful career in HEOR?
I think it’s being able to embrace the way the field changes and develops. Every now and then you will encounter a complex problem and, instead of shaving away the complexity, you should delve into it. Don’t be afraid to get into the messiness of it, because that is where the real insights come from. That is how you widen the conversation to include people who have not been heard before.