Lesher makes her mark in outcomes research

Beth Lesher has a Pharm.D. So on a typical day she might, say, write a value dossier for a company expanding into Egypt and the Ukraine.

Wait, what? Pharmacists do that?

They certainly can. Lesher has parlayed her MUSC pharmacy degree into a career in health economics outcomes research (HEOR), currently serving as a senior director in the Strategic Market Access Center of Excellence for Open Health (previously Pharmerit, International which was acquired by Open Health in 2019).

She’s also introducing HEOR careers to pharmacy students like Sarah Criddle ’21, who did a rotation with Open Health earlier this year and has subsequently been hired full-time.

“Pharmacy students don’t always realize just how many options they have with a pharmacy degree,” Lesher said. “Students need to understand they have this phenomenal background and there are a lot more opportunities out there than they think.”

 

An emergent field

One of those opportunities is in outcomes research, which has flourished as a specialty in the last few decades. HEOR is now a critical component for successful strategic planning in the pharmaceutical industry, the health insurance industry, healthcare advocacy organizations, and national public health programs.

• Smart companies rely on outcomes analysis to do everything from establishing the value of a drug to setting its price

• Healthcare advocates use its data to communicate the prevalence and impact of different disease states and therapies

• Ministries of health need HEOR to focus public funding in areas that will generate the best return on investment in the health of its citizenry

Most of Lesher’s work is with the pharmaceutical industry. On any given day, she and her team might be juggling as many as 15-20 projects, ranging from systematic literature reviews to database analysrs to helping authors publish their research.

“Some outcomes pharmacists work for a specific drug at a company,” she said. “As a consultant, you get to be involved in multiple drugs and diseases.”

For example, a company might come to Open Health with a promising new drug, just entering Phase I trials to treat some disease. Open Health may conduct a systematic review of the literature and develop a value dossier that includes:

• how many people have the disease

• how many would be treated by the proposed drug

• what kind of market they could reasonably expect

• a breakdown by country of all the information

The value dossier would identify the disease burden, establish that there is an unmet need, and provide evidence that the product meets that need. These data are required to enter the markets in Europe and Asia and obtain market access in the United States

The growth of HEOR professionals has led practitioners to develop or tap more fully into three key areas: patient-reported outcomes, real-world evidence, and economic modeling techniques. A drug may have clear safety and efficacy results like “extends life by four months” but HEOR might find that, with two of those four months spent in the hospital, patients are choosing to forego the therapy due to cost and quality of life issues.

“More and more we are realizing the importance of the patient’s opinion in treatment decisions, particularly during treatment for life-long chronic disease and for end of life care,” she said. “Prescribing therapies that are safe and effective is not enough. We must make sure that our recommendations are not only safe and effective but take the patient voice into account.”

 

An unusual path

Lesher got a bachelor’s degree in pharmacy from Ohio Northern University and then came to MUSC to get her Pharm.D., where she came under the wing of mentor Walt Uber ’88. She started working as a clinical care pharmacist and as an assistant professor at Hampton University. She also got interested in medical writing, which turned out to be the perfect freelance job while she was raising three children.

Then she got a call from Jenny Stephens ’94, a classmate who was a partner and clinical director of Pharmerit International. Stephens asked, “Have you ever written one of these global value dossiers?” Lesher dove right in. She eventually joined Pharmerit as lead scientist, medical communications.

Today, she oversees a team of half a dozen people, anchored by two women she has trained for 4-5 years.

“I learned from Walt Uber the importance of communicating that you are not expected to know everything, you are supposed to learn,” she said. “The first time with Walt Uber, he’d say ‘I didn’t expect you to know that people need to stop aspirin before surgery. But now you do.’ The first time somebody writes a dossier, I tell them ‘I didn’t expect you to know that was a dangling participle. Now you do.’

“One of the most important things I got from my MUSC education was how to clearly present data. Some of the things you learn in pharmacy school – like how to identify and evaluate the literature or how to communicate to healthcare professionals and patients – will never be outdated.”