In a recent episode of the Pharma Perspective podcast, I sat down with Barinder Singh, founder of Pharmacoevidence, to talk about leadership, risk, and what it means to do meaningful work in health economics.

Barinder’s journey isn’t a typical start-up story. He left a stable consulting role during the height of the COVID pandemic—while his wife was pregnant—to build something of his own. Not because the timing was ideal or the economics obvious, but because staying still felt riskier than moving forward. That decision, grounded in responsibility rather than optimism, shaped how he thinks about work, leadership, and growth.

A recurring theme in our conversation was how small details in evidence can have outsized consequences. In HEOR, a single study buried among thousands of citations can change the direction of a submission—and, by extension, affect access to treatment for real patients.

Barinder’s background in pharmacology and research gave him a strong appreciation for this responsibility early on. Over time, that mindset carried into systematic reviews, indirect treatment comparisons, and HTA submissions. Evidence, in this context, isn’t abstract. It’s the foundation for decisions that shape patient outcomes.

We also spoke candidly about consulting life and leadership. One insight that stood out was the importance of technical leadership in a field as specialised as HEOR. When leaders understand the methodological detail, teams are better supported—and quality is easier to protect.

Barinder shared how workload pressure, resourcing constraints, and poor leadership can quietly erode evidence quality. These experiences heavily influenced how he built PharmaCo Evidence: prioritising sustainable growth, investing in people, and resisting the temptation to scale faster than the work allows.

The hiring landscape in HEOR has changed dramatically over the past five years. Where talent shortages once dominated, today there’s more uncertainty—particularly for early-career professionals.

Barinder described a deliberately narrow hiring approach, long-term investment in junior staff, and a strong emphasis on exposure and development. The goal isn’t just to fill roles, but to build teams capable of handling complex evidence responsibly, even as demand fluctuates.

No conversation about HEOR would be complete without discussing NICE and HTA decision-making. While NICE sets global standards for methodological guidance, Barinder highlighted a tension many practitioners recognise: even when guidance is followed rigorously, outcomes can still vary.

Committee composition, reviewer experience, and interpretation all introduce subjectivity. As a result, successful submissions increasingly depend not only on methodological correctness, but on anticipation—understanding where challenges are likely to arise and preparing for them in advance.

Looking ahead, much of our discussion focused on AI and technology. Barinder sees enormous potential in using AI to support evidence generation—particularly for repetitive, time-consuming tasks like screening and drafting—while keeping humans firmly in control of interpretation and sign-off.

Rather than replacing expertise, AI can free up time for strategy, judgment, and deeper thinking. Used well, it can speed up access to medicines while maintaining rigor. Used poorly, it risks undermining trust. The distinction, he argues, comes down to validation, transparency, and human oversight.

Ultimately, this conversation goes beyond methods, tools, or even career advice. It’s about choosing responsibility over comfort, building something thoughtfully in uncertain conditions, and maintaining discipline when outcomes aren’t guaranteed.

Barinder’s story is a reminder that the most meaningful paths—professionally and personally—are rarely the easiest ones. But they are often the ones that matter most.