Starting a Career in HEOR With an Industry Fellowship: What’s Next?
Soham Shukla, PharmD, MS; Dawn Kim-Romo, PharmD, PhD, MS; Alejandra Murillo, BS, Rutgers Center for Health Outcomes, Policy, and Economics, Piscataway, NJ, USA
Introduction
In the field of health economics and outcomes research (HEOR), completion of a fellowship in the biopharmaceutical industry provides advanced degree holders accelerated HEOR-applied training as well as exposure to the biopharmaceutical industry and the corporate matrix environment.1 HEOR fellowships were introduced soon after the advent of the field of HEOR and over time, have grown in their breadth and scope, allowing for more opportunities postfellowship.2
With the increased rigor of fellowship programs (eg, most offer a combined master’s degree) and diverse project and leadership opportunities, fellows have more doors open to them now than ever before.3 Yet, it should be noted that fellowship salaries have remained largely the same as they were 30 years ago when the first HEOR fellows were completing their fellowships.4
The authors conducted a survey to understand the current career opportunities and trajectories available after completing an HEOR fellowship. As the interest and competition in HEOR roles have increased, so has the role played by HEOR fellowships in enabling job attainment. To our knowledge, this survey is the first attempt in the literature to identify the characteristics of HEOR fellows and understand their transition into employment postfellowship.
Methods
We utilized a 17-question cross-sectional online survey to understand fellows’ baseline educational status, fellowship experience, and career outlook after fellowship. Additionally, we offered fellows the opportunity to provide feedback on difficulties faced during the job search and advice they would give to future fellows. A convenience sample of current and past fellows was obtained through an HEOR Fellow Workgroup established in 2017. This workgroup is unaffiliated with any specific professional organization and provides a network for current HEOR professionals completing an HEOR fellowship in the United States. The group includes over 100 active members and alumni. To be included in the study, participants had to self-report as a past or present fellow whose fellowship focused on HEOR.
Results
We received a total of 34 responses. The sample included respondents who began their programs between 2004 and 2021. All but one respondent had their PharmD prior to entering their fellowship program. Approximately two thirds of respondents participated in an officially combined master’s fellowship program, and most, but not all, completed their master’s degrees.
"With the increased rigor of fellowship programs (eg, most offer a combined master’s degree) and diverse project and leadership opportunities, fellows have more doors open to them now than ever before."
Twenty-eight respondents indicated their fellowship programs were intended to be up to 2 years long. Of the evaluable responses, the average length of fellowship participation was 19 months. Respondents started their search for their next job on average approximately 15 months into their fellowship. Common reasons for starting the job search included new employment opportunities within the fellowship company, desire to expand career growth, and explore other interests, and nearing the completion of the fellowship program.
When asked about which job sectors respondents applied to during their search, most applied within the biopharmaceutical industry. Eighty percent of respondents applied to large biopharmaceutical companies (>100K employees), 70% to medium (10K-100K employees), and 40% to small (<10K). The next largest category of applications was for consulting jobs (30%). Most respondents (97%) successfully obtained 1 to 2 job offers, where the base salary offered was $132,882 per year. The 2 most reported job title/level of the positions accepted were “Manager” and “Senior Manager” (40% each). Only 3 respondents accepted a job at the “Associate Director” level. There were 3 “Other” category responses, 1 each of “pharmacist,” “contractor,” and “scientist.” Although our analyses are limited by sample size and we are unable to show significance, average base salary trended towards being higher based on title: Associate Director ($152K, N=3), Senior Manager ($141K, N=14), Manager ($126K, N=14). Base salary was also higher for fellows completing their fellowship after 2018 ($137K, N=23) than before 2018 ($124K, N=11), which could be due to a mix of inflation but also reflecting the increased rigor of fellowships in recent years. Base salary was higher for the 16 respondents with another degree in addition to a PharmD than the 18 respondents with just a PharmD ($139K vs $128K).
After negotiation, fellows reported negotiated salary increases ranging from 0% to 23% over the initial offer. The 2 most offered incentives were annual bonuses (75%) and long-term incentives/stock options (60%). Other incentives offered were relocation (32%), sign-on bonuses, tuition reimbursement, and the ability to work remotely (38% each). Respondents reported being able to negotiate higher rates in any of the surveyed categories, including the incentives above, with increases in sign-on bonuses as being the most frequent (20%).
In order of most common to least common, the reported difficulties faced during the postfellowship job search include: the lack of job openings and opportunities, pandemic-related challenges due to COVID-19, perceived inadequate educational degrees or HEOR experience, lack of fellowship program support with recruitment, difficulties during job negotiations, and perceived higher competition with current internal company candidates. Finally, respondents were asked to provide prospective fellows advice for their next job search. The responses could be broadly categorized and the 3 most common themes were: (1) start the job search process early, even before the fellowship is complete; (2) build and utilize your professional network; and (3) do not discount the importance of salary negotiation.
Takeaways
This study assessed the demographics, fellowship participation, and job prospects of HEOR fellowship participants. Over 97% of participants had obtained PharmD degrees before beginning their HEOR fellowships. While the intended duration of respondents’ fellowships was most frequently up to 2 years, the majority began looking for a job after 15 months into their programs. Surprisingly, one of the reported barriers to finding the first job after the fellowship was the perceived lack of training or experience for HEOR jobs. We speculate this could be a result of either the fellows’ unmet needs unrelated to training during the fellowship (eg, obtaining a PhD) or a mismatch between the training and experience in the fellowship versus the experience required by prospective employers. While future research is required to further understand this observation, respondents frequently advised future fellows to start the job search early in the program and to build and utilize their professional network.
The generalizability of the study results is limited to PharmD fellows who participated in biopharmaceutical industry and consulting-based programs, and results may not reflect those who have participated in institutional or academically based programs in HEOR.
Selection bias may have occurred during data collection especially if participants only reflect a subset of candidates who were more willing to participate, had the time to participate, or believed themselves to be “successful” in their job searches. Finally, biases related to nonresponse, social desirability, and recall could not be ruled out by the authors.
Final Thoughts
Despite the challenges reported by the survey respondents all obtained employment after participation in their HEOR fellowships. The majority of survey participants found employment within the biopharmaceutical industry or in consulting. Interestingly, academia and healthcare positions (hospital or community pharmacy) were the least reported employment categories. Overall, fellowships remain a valuable segue into the field of HEOR. Thus, for future HEOR fellows we share the following advice: be proactive, patient, and persistent and according to one respondent, “Trust that it will all work out.”
References
1. Kane-Gill S, Reddy P, Gupta SR, et al. Guidelines for pharmacoeconomic and outcomes research fellowship training programs: Joint guidelines from the American College of Clinical Pharmacy and the International Society of Pharmacoeconomics and Outcomes Research. Pharmacotherapy. 2008;28(12):1552.
2. Shukla S, Khan Z, Pizzi L, et al. Relevance of the ISPOR Competencies Framework in HEOR Fellowships in the United States. Value & Outcomes Spotlight. 2021;7(3):28-29.
3. Thomas S. Have you heard about HEOR?: A Q&A with a fellow at the Program. Pharmacy Times. Published September 5 2017. Accessed August 30, 2021. https://www.pharmacytimes.com/view/have-you-heard-about-heor-a-qa-with-a-fellow-at-the-program.
4. Rule B, Fiore J, Murray B. Assessing the current landscape of pharmaceutical industry post-doctoral PharmD fellowships. Presented at the Drug Information Association (DIA) 51st Annual Meeting. Published 2015. Accessed August 30, 2021. https://pharmafellows.rutgers.edu/wp-content/uploads/2020/08/2015-assessingthecurrentlandscapeofpharmaceuticalindustrypost-doctoralpharm.d.fellowships.pdf.
