Dream Big Health

When healthcare innovators bring new diagnostics, medical devices, or pharmaceutical therapies to market, they often face the same challenge: the evidence required by payers does not yet exist. Dream Big Health (DBH) specializes in bridging the gap by generating credible, payer-ready evidence for both MedTech and pharmaceutical companies, especially those with first-in-class or hard-to-compare technologies.

DBH operates at the intersection of HEOR, clinical utility research, and real-world evidence. Instead of relying on limited or single-study data, the firm builds evidence from the ground up using systematic literature reviews, meta-analyses, machine learning, and indirect treatment comparisons. This approach supports diagnostics, medical devices, AI/digital platforms, and pharmaceutical therapeutics development, including Phase 3 trial planning and patient-reported outcome (PRO) strategies.

“We work where evidence doesn’t exist yet,” says Holly Varnell, co-founder and CEO. “Our job is to translate innovation into validated, payer-relevant value.”

A defining differentiator is DBH’s independent, third-party modeling. Traditional manufacturer budget impact models often rely on narrow inputs or optimistic assumptions. DBH’s Value and Evidence Framework incorporates broader, deeper evidence—establishing measurable, comparable clinical, economic, and quality-of-life metrics and utilizing real-world data—to deliver models that more accurately reflect clinical practice. The work is based on independent evidence or research, incorporating RWD from a multitude of sources (not hand-selected or otherwise biased) for each metric to provide a more accurate depiction of clinical practice reality.

This independence also extends to pricing strategy. DBH’s AI-enabled intellAIpricing platform integrates the evidence generated through DBH’s analyses to determine value-based pricing for both medical technologies and pharmaceuticals. By weighing clinical quality (or safety), economic impact, and clinical & analytical validity (or efficacy), the platform provides transparent pricing rationales and payer-aligned scenarios that clients can defend.

DBH’s work spans both sides of the innovation landscape. For MedTech and diagnostics, the firm frequently demonstrates clinical utility—how a new test or device changes physician behavior, accelerates diagnosis, or improves outcomes. For pharmaceutical partners, DBH supports evidence strategies for new indications, comparative effectiveness when no head-to-head data exist, and PROMs planning for trials where payer acceptance hinges on meaningful patient outcomes.

Recent engagements illustrate the range. DBH helped a diagnostics company model clinical accuracy, quality improvements, and cost impact to support successful reimbursement discussions. In another example, DBH conducted chronic disease economic modeling for a pharmaceutical partner to characterize long-term disability progression and estimate the budget impact of a new therapy in an area lacking an established clinical indication. The disease spans five evolving phenotypes along a continuous spectrum, which prevented traditional state-based models from capturing progression meaningfully. DBH therefore designed a first-of-its-kind PIRA-driven modeling framework to isolate relapse-independent progression, an approach that succeeded where other vendors’ models failed.

Behind this work is a senior, multidisciplinary team. DBH’s experts include a former national medical director with 16+ years at major U.S. health plans, an international health economist with more than 200 peer-reviewed publications, market access and reimbursement executives, and clinical data scientists who develop novel ML regression models. Leadership also contributes to the national Medicare and Medicaid recommendations committee for pre-rulemaking Clinical Quality Measures (CQM), providing insights into population health and helping DBH understand how evidence standards and reimbursement criteria are shaped at the policy level.

The firm partners closely with C-Suite, HEOR Directors, Value & Evidence Leads, Medical Directors, and Market Access teams across pharmaceutical and MedTech companies. Acting as an independent bridge between manufacturers, payers, and providers, DBH ensures every piece of evidence—clinical, economic, or experiential—aligns with real-world decision-making.

By grounding innovation in validated evidence, Dream Big Health helps its clients move from possibility towards payer recognition and acceptance, ensuring that transformative therapies, diagnostics, and technologies reach the patients who need them most.