Julie Frappier – Health economist & Founder of Data 4 Actions and TOWWERS program

Active in the health economic field since the late 80s, with more than 20 years of health economics consultancy experience in the North American and European Life Science field, Julie has established a reputation for excellence in the planning and implementation of pragmatic health economic and outcome research that meet and exceed expectations of clients, healthcare professionals, patient advocacy groups and third-party payers. Over the last 10 years, she has collaborated to the success of a project in Japan and many European projects in the UK, Austria and Spain. She was also invited as a guest speaker at the Scottish Medicine Consortium.

In her work on more than 250 health economic projects, Julie has maintained a focus on economic piggyback studies, economic models, economic risk management trials, price justification, economic market identification and justification, clinical registries and patient/disease management programs.

Julie has acted as an advisor in health economic studies for the Quebec Hospital Association (AHQ) and filled the role of chairperson to the1st AHQ pharmacoeconomic workshop in 1993. Julie has also been a speaker at many conferences.

Julie has been interviewed and quoted by the Pharmacoeconomics Prix Galien supplement, has been a member of the DIA’s Canadian & North American Programme Steering Committee. La Presse asked her to write a full-page article in the Editorial section regarding drug development costs (April 2002). She has published many papers and posters with the Journal of Medical Economics, the Montréal Economic Institute, Québec Pharmacie, the Drug Information Association (DIA) and other journals/events.

Julie has furthermore maintained a close and lasting relationship with the academic community. She has aided doctoral students as thesis pragmatic expert and has been a lecturer for Master’s students at the University of Montreal’s economic department. From 2002-2006, Julie taught health economics at the MBA (MBA 8B1B) level for the group specialized in bio-industries. She has also co-authored a book chapter about health economics of depression (Thérapeutique Psychiatrique, Éd. Hermann, 1995) and she is also the author of the ABCs of Pharmacoeconomics: a Reference Guide.

Today Julie is working on a novel collaborative program (the TOWWERS program) that aims the optimal use of medication and medical technologies. She strongly believes that cost is not the enemy, waste is. Hence, if we wish to tackle the healthcare cost increase issue, cost containment strategies are simply fuelling the problematic. She strongly believes that the best approach to cost savings is to improve health status. This revolutionary project integrates all her recognized expertise:

  • Economic risk management to market access and return on investment optimization
  • Health economic evaluations (for reimbursement purposes)
  • Optimal use and therapeutic plans
  • Real world evidence (RWE)
  • Health registries
  • Large spectrum collaborative projects involving the 5Ps

Why Health Economics?

Attention regarding the relationship between costs and efficacy of life sciences is relatively recent. The urgent need for health outcomes research was highlighted in the early 80s. Considering the spiraling escalating rise in healthcare costs, the demand for a more rational allocations of life science products and services has never been more crucial. For instance, 4 decades ago, physicians only had to choose among available interventions by referring to clinical endpoints (safety and efficacy); sales representatives would inform physicians on a given product and expect them to prescribe and adopt it.

Whether they like it or not, healthcare professionals must now also examine costs, as governments, hospitals and private third party payers are striving to optimize care to patients subject to their existing budgets. A product has no longer to be safe and efficacious; it must also be efficient. On the other side, the struggle of generating a positive return on investment for healthcare products and services has never been more challenging.

Since healthcare professionals, payers, policymakers and producers of healthcare technologies are often faced with the difficult task of assessing the value of a new product or justifying the addition of a new clinical service, either costs, effectiveness or market size is often the only factor considered.

No matter how wealthy the economy of a nation is and how strong its economic system is, there will never be unlimited resources to satisfy the society’s needs. Policymakers, consumers, producers of healthcare technologies, payers and all other individuals and groups involved in the economy must make hard choices about how to allocate resources.

When individuals choose to purchase a medication, they cannot use the same money to purchase something else. Similarly, when governmental policymakers authorize expenditures on medications, there are competing demands that cannot be fulfilled. This idea can be generalized into one of the most important concepts guiding economics: the opportunity cost. Economics, whether applied to life sciences or to any other goods and services, is not about reducing costs (cost containment strategies), it is about maximizing their net outcomes subject to society’s given available resources.

Most of the actual interventions seek to control costs rather than to improve the efficiency of resource allocation. Sound economic studies seek to improve the methodological issues and principles of clinico-economic evaluations.

Finally, it is not important for healthcare actors to be able to perform health economic studies but it is essential for them to understand how and why these analyses are performed and thus, why certain recommendations were outlined. Healthcare actors should remember that the national Healthcare system is seeking to deliver the most efficient healthcare, not the cheapest one.

Spending is not the enemy – wasting is!

Why Health Economics with Data 4 Actions?

Data 4 Actions is a research group specialized in behavioural health economics. Our strength is that we master microeconomic underlying notions that can translate into a powerful research protocol and report that will have the ability to influence end-users about the economic relevance of a given product or service.

At Data 4 Actions, we go beyond writing a report with rigorous and sound clinico-economic data. We strive to translate data into a compelling story that will trigger the need to take action by the 5P 1 s; rather than opting for strategies dealing primarily with cost-containment that will ultimately lead to wastage.

How do we build each customized story? We build them, over and above our experience, expertise and dedication to success for each of the 5Ps, through:

  • An adapted multi-disciplinary team
  • A customized needs assessment questionnaire
  • An adapted pragmatic team to validate the research hypotheses and study rationale
    • Regardless of the quality of the research, if the research hypothesis and study rationale is sub-optimal, it is most likely that results will become sub-optimal since we know the adage: “Garbage in… garbage out”.
  • By transferring key economic notions into a relevant data collection form
  • By validating our underlying assumptions with real-life experts
  • Using appropriate check-lists to assure the soundness of the method and the
  • Publication as well as assuring transparent and conservative assumptions
  • By proposing the most optimal story and justifying the underlying assumptions where the 5Ps will all be in a Pareto optimal situation: a win-win

The GLPS of the 5Ps


Julie loves to share her passion and experience about health economics. Hence, she was invited to be a spokesperson in many events. These events mostly consist of:


  • OECD –2017 (Paris)
  • London School of Economic – Key note speaker of the conference “Rethinking Healthcare” (London) (2017)
  • Merieux Institute (2019)
  • DayOne – Toulouse (2017)
  • iHEA (2015) – Milan
  • ISPOR (2015) – Milan
  • Maitre chez Vous (2015) – Montreal
  • Personalized Medicine Conference (keynote opening speaker) – Montreal 2014
  • Strategic Pricing Symposium (Montreal)
  • Oswestry Cartilage Meeting (UK) – 2014
  • BioMedex (Montreal)
  • Montreal Economic Institute (Montreal)
  • Drug Information Association (San Diego, USA)
  • Piramal (Madrid) – 2014
  • AOP Orphan (Vienna) – 2016
  • Wound Care Congress (Montreal)
  • World Vaccine (Montreal)
  • Les médicaments en l’an 2000, Virage 98 (Montreal) – Chairman of the first pharmacoeconomic workshop (1993)
  • Annual symposium – Association des hôpitaux du Québec (Montreal)
  • BioAlliance Canada-Maroc (Montreal)
  • Others


  • UQAM (lecturer) – MBA department
  • Université Laval – Presentation to the infectious disorder department (Quebec)
  • Université Laval – Guest speaker
  • Université de Montréal – Guest speaker
  • Pragmatic thesis expert (1999)
  • Pragmatic thesis expert (2015)
  • UQAM – Guest speaker


  • Scottish Medicines Consortium (Scotland 2015- 2016-2017)
  • INESSS (Institut National d’excellence en services santé et en services sociaux) 2017
  • Presentation to the Minister of Health (Québec) – 2016
  • Health Canada (various departments)
  • Health Canada : Health Economic Training


  • CADTH (Canada)
  • ISPOR – North American (Spring)
  • ISPOR – Europe (Fall)


Over the last 25 years, Julie built “health economic stories”. Please find hereunder a list of the impact of some of her projects.

Justify the economic efficiency of healthcare technologies (Canada, USA, Europe)
Through the economic strategies that were designed in collaboration with the client, many products were listed for reimbursement; even for products that were highly challenging due to their significant premium price to competition.

Economic piggy-back to a clinical trial
Collaborated to the economic strategy and implantation of international clinical trials, implicating up to 7 countries; for phase I to phase IV trials, secondary or primary to a clinical trial strategy/design.

Price justification
Through various complementary rigorous economic assessments, managed to influence a top 5 worldwide pharmaceutical to adapt an independent Canadian pricing strategy (significant price reduction of the medication)

Ethics committee
100% of the projects that were submitted were approved by the ethics committees (hospital/private)

Market justification
Through the results of Willingness-to-pay trials results generated significant impact on the redesign of the strategic business plan. Collaborated with many small biopharma’s to assess the economic market risk/value of their various indications; frequent collaboration to assist them in the complex task of go/no analyses through economic data.

Patient/Disease management
Collaborated to strategies and implementation of large multi-center trials; implicating more than 3000 patients and 500 physicians.

Health Policy
Project leader for l’Institut Économique de Montréal to determine the feasibility and success factors for enabling nurses and specialized physicians to offer their services in the private sector, over and above their actual scope in the public sector.

Go/No Go – Venture capital firm
Collaborated with venture capital firms to assess the economic risks of investing healthcare technology firms (go/no go). Collaborated with healthcare technology firms to strengthen their business plan (through economic data) to optimize investment funds from venture capital firms and pharmaceuticals.


Over the last 25 years, Julie has performed projects in various indications and adapting various methodologies. Please find hereunder a list of her various experience over the last 25 years.


  • Anesthesia
  • Alzheimer’s disease
  • Asthma
  • Bipolar disorders
  • Bronchitis
  • Cancer
  • Cardiovascular management
  • Cardiovascular prevention
  • Cartilage repair
  • Chronic disorders prevention
  • Chronic heart failure
  • Clostridium difficile
  • Coagulation
  • Colorectal cancer
  • COPD
  • Depression
  • Dermatitis
  • Emergency contraception
  • Erectile dysfunction
  • Fungus
  • GBS for intrapartum maternity patients
  • gestational diabetes mellitus
  • Hand hygiene program
  • Heart failure
  • Hepatitis C
  • HIV / HIV-associated lipohjypertrophy
  • Hypertension
  • Infectious disorders
  • Leg ulcers
  • Lipodystrophy
  • Lung transplantation
  • Medical Tourism
  • Medication distribution system
  • Migraine
  • Myocardial infarction prevention
  • Neutropenia
  • Nosocomial infections
  • Osteoarthritis
  • Pain
  • Physical activity
  • Pneumonia
  • Policymaking
  • Prevention of C-sections
  • Psoriasis
  • Pulmonary hypertension
  • Radiosynovectomy
  • Renal Transplantation
  • Rheumatoid arthritis
  • Schizophrenia
  • Severe infections
  • Sleep disorders
  • Stroke
  • Telemedicine
  • Upper body disablement
  • Urinary tract infections
  • Vaccines
  • Virtual surgery simulation

Types of Projects

  • Burden of illness study
  • Delphi panel
  • Disease management program
  • Economic clinico-economic model
  • Economic piggyback trial
  • Economic Risk management trial
  • Literature review
  • Optimal utilization of medication
  • Patient management program
  • Phase IV
  • Pilot project
  • Prospective trial
  • Registry
  • Retrospective trial
  • Time and motion study
  • Willingness to pay



For the past 30 years, healthcare costs have represented a growing proportion of the governmental budget, despite all its efforts to contain them. This phenomenon is not limited to Canada (Quebec) but rather represents a worldwide issue. Moreover, WHO and OECD members have shared views and options on how to design and implement the future of healthcare and recommendations for strong reforms in January 2017.

The OECD issued in 2017 recommendations:

  • Promoting high-value health systems for all
  • Adapting health systems to new technologies and innovation
  • Reorienting health systems to become more people-centred
  • Encouraging dialogue and international co-operation

The TOWWERS program is designed to tackle these issues.


The TOWWERS program’s mission is to foster health and wealth of a nation by convening healthcare stakeholders to measure and improve patient outcomes.

The TOWWERS program is the first dynamic and interactive populational clinical registry which will facilitate the creation of a link between:

  • The diagnosis and co-morbidities
  • The therapeutic plans
  • Achievement of therapeutic targets (real-world evidence)
  • Risk and success factors involving patients, healthcare professionals and the system

The TOWWERS program has as its objective the progressive transformation of the current paradigm on healthcare policy based on budgetary targets (quantitative markers) towards one that is based on health improvement. It serves as a tool to break down silos, track the evolution of the patient health, ensure optimal use of the therapeutic plans though the integration of dashboards and toolbox including interventions tailored to patients’ and healthcare professionals’ needs.

The TOWWERS program is an apolitical, independent, transparent and collaborative approach whose ultimate objective is to promote an environment that strives to optimize the achievement and maintenance of therapeutic goals in order to increase the populational health and wellness of a nation.

To ensure its success, the TOWWERS program will engage the various healthcare stakeholders and will require their collaboration and the accountability in order to develop relevant strategies for market access and track the effectiveness (real-world evidence) of therapeutic action plans in different contexts.

Each therapeutic indication will generate a customized therapeutic unit composed of :

  • Patient advocacy groups
  • Healthcare professionals (Nurse, Pharmacist, Specialist (KOL), Primary care physician)
  • Policymakers
  • Payers (public & private)
  • Healthcare producers

The targeted therapeutic indications will consist of recognized chronic disorders where there is a significant care gap for reaching therapeutic goals, such as:

  • Type 2 diabetes
  • Hypertension / cholesterol /Other cardiovascular conditions
  • Depression / anxiety
  • Asthma / COPD
  • Osteoarthritis
  • Other medical conditions may be recommended by any 5Ps member

Who we are

Julie Frappier, President and Founder
Active in the health economic field since the late 80s, with more than 30 years of health economics experience in the North American and European Life Science field, Julie has established a reputation for excellence in the planning and implementation of pragmatic health economic and outcome research in collaboration with healthcare professionals, patient advocacy groups, governments and third-party payers. In her work on more than 200 projects, Julie has maintained a focus on economic models, clinical registries and patient/disease management programs. She has furthermore maintained a close and lasting relationship with the academic community. From 2002-2006, Julie taught health economics at the MBA level specialized for bio-industries. Julie is the creator behind the TOWWERS program that aims at reaching and maintaining the optimal use of therapeutic plans based on populational real-world evidence in collaboration with the 5Ps. She strongly believes that cost is not the enemy, waste is and that the best approach to cost savings is to improve health.

Martine Larose, CFO-CTO
Martine is a Manager and an entrepreneur involved in IT solutions over the last 25 years. She holds an eMBA and has strong management experience in IT and is recognized for her capacity to analyze and synthesize complex situations and drive concrete solutions using the latest technologies. She particularly excels as a facilitator between various stakeholders. She showcases the best of everyone, highlighting and using each other’s strengths, so that projects are transformed into success.

Together for tomorrow’s health. Together for tomorrow’s wealth.


Julie Frappier, B.Sc. & M. Sc. Economics
President and Founder of the TOWWERS program
1380 Boul. René-Lévesque ouest, bureau 3702Montréal, Qc, H3G 0E4

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