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The Official News & Technical Journal Of The International Society For Pharmacoeconomics And Outcomes Research
Outgoing Presidential Address: International Transition – A Year in Review


Diana Brixner PhD, 2007-2008 ISPOR President and Professor and Chair of the Department of Pharmacotherapy and Executive Director of the Pharmacotherapy Outcomes Research Center at the University of Utah College of Pharmacy, Salt Lake City, UT, USA


It is hard to believe that a year has passed since our last international meeting. Only after being President, can you really appreciate some of the comments that previous presidents have made before you. I remember last year, Michael Drummond gave his outgoing address, and it was entitled, “A Year is a Long Time in ISPOR. It is amazing to see firsthand how much this organization accomplishes in one year. I also remember a few years ago when Sean Sullivan gave his outgoing address, and noted that he was counting down the days until the next president took over. I believe all past presidents would agree, the demands of this organization are intense, however the reward of the dedicated membership, leadership and staff are seen around the world again and again.

The theme of my comments for you this morning is International Transition: A Year in Review. Despite the fact that it is clear the goals of this organization has been to be truly international from the beginning, 13 years ago, in this particular year some significant milestones have occurred, truly confirming our growing international strength for this organization. I have organized my comments as follows: 1) background on who we are: our membership and our global representation; 2) a review of what it is we do as an organization; and 3) where we are going, reminding you of our vision and what we have achieved to get there. Finally, I would like to take the opportunity for some appreciations.

Who is ISPOR?
Membership. ISPOR's numbers and statistics are really impressive. We now have a membership of over 4,100 individuals and these members come from 96 different countries. When I saw this statistic I was curious as to what is the denominator? How many countries are there in our world anyway? So I googled, as we all would, “how many countries are in the world,” and came back with 195 countries. So the reality is that almost 50% of the countries in the world are members and represented by ISPOR. It is also interesting to note that out of our 4,100 members we have over 2,000 attendees at this meeting. So it is impressive to know that 50% of our membership is at the 13th Annual International Meeting in Toronto.

In terms of representation of our membership, if we look by work environment, the groups that are represented include health researchers, as well as health care decision makers worldwide including pharmacists, physicians, economists, nurses and researchers from academic, pharmaceutical and biotech industry, government, managed care, health research organizations, and purchasers of health care. It is of great interest is to look at our decision maker practitioner representation, clinical practice, and managed care, and the government. Last year, those numbers were 1%for each of those pie pieces. We have grown our membership in clinical practice managed care and government to 6% and 11% respectively. This is really impressive and again, very much in line with one of our key strategies to grow the membership in the area of decision makers.

We can also look at our membership by research interest. Based on all of the abstract submissions for this meeting we have presentations and posters in the area of cost studies and also in clinical outcome studies, patient reported outcomes, health care use and policy studies and then also research methods. We continue to represent a diverse perspective on the research that we do.

As to our representation by geographic region we continue to decrease the presence of the United States in order to make this more of a global and international organization. Since last year, we went from 49% to 48% representation in North America, and the gain was in Canada which makes sense as our 13th Annual Meeting is in Toronto. We continue to have 34% of our membership that comes from Europe and growing representation from the Asia- Pacific region, Russia, Africa, and Latin America regions. But what strikes me more than the growing global representation for the organization which changes slowly from year to year, is a significant increase in infrastructure around our global initiatives and membership. First let me share with you our regional consortia. We have the ISPOR Asia Consortium and now also the ISPOR Latin America Consortium. I had the great privilege of opening the inaugural ISPOR Latin America Conference in Cartagena, Columbia, in September 2007. It was a real joy to be welcomed by our warm colleagues in Latin America as well as the warm and humid climate of Columbia. But nonetheless it was really exciting to see almost 300 members of the consortium were at the meeting in Latin America and a tremendous enthusiasm for learning the principles of pharmacoeconomics and outcomes research and how to apply them to drug reimbursement. Of course we are all looking forward to our 3rd Asia-Pacific Conference which will be in Seoul, Korea in September.

Local Chapters. We have also seen some impressive growth in our local chapters. Just in the last year we have added seven new local chapters to the organization and at the most recent ISPOR Board Meeting, we approved three more; Australia, Croatia, and Jordan, to a total of 10 added in the last year, and a total of 28 local chapters. The amount of activity that goes on in these local chapters is really impressive. During the last year I had the privilege to visit two of the local chapter organizations. First in Greece, last September, I was invited to the (HELSPOR) Group, the Hellenic Society of Pharmacoeconomics and Outcome Research, and met with Dr. Mary Geitona who is the President of the Greek Chapter and also with John Yfantopoulos who is one of our two program co-chairs for our upcoming European Congress in Athens, Greece.

Just last month I had the privilege to attend the summer school and co-host this program with the President of the Turkey Chapter, in Antalya Turkey. Once again, there were over 100 people at this meeting, individuals from the reimbursement agencies, industry and from universities, all trying to learn the principles of pharmacoeconomics and understand how they can be applied to drug reimbursement in their country. My cohost there was Dr. Cankat Tulunay. The capacity of these local chapters to bring the tools of ISPOR to the local environment is truly impressive, as well as all the size of the membership of these chapters. The members of the local chapters do not need to be members of ISPOR which allows them to appreciate the resources and tools of this organization. And in fact, if we look at all of the members of local chapters that are then affiliated with ISPOR our true membership with affiliations is close to 10,000 individuals around the world.

So once again the activity of our local chapters is impressive, and the obligation of our organization to provide the resources to support these chapters is also very important.

What ISPOR Does
Meetings. I will now switch gears to focus on what we do as an organization. One of the most important things we do is to have meetings around the world to give us all the opportunity to get together and share our research and ideas for application to reimbursement. First our meetings in North America, we are all here in Toronto today, and our next meetings will be in Orlando, Atlanta, and Baltimore, respectively. Next let's take a look at our Congresses that will be happening in Europe. We will all be in Athens this fall for our next European congress. Our program chairs there will be John Yfantopoulos and Uwe Siebert. From there, we will be going to Paris, France in 2009, Prague, Czech Republic in 2010, and potentially Vienna, Austria in 2011.

As previously mentioned, we now have our regional Coferences to support our regional consortia. For the Asia-Pacific Conference we will be having the meeting in Seoul in September, and then the next meeting will be in Phuket, Thailand in 2010. And for our Latin America Consortium, in 2009 the meeting will be in Brazil, and then the following meeting two years later, will be in Mexico in 2011.

Resources. ISPOR's extensive resources provided to our members and our chapters around the world include access to various databases on the ISPOR website, www.ispor.org. We have databases of international pharmacoeconomics guidelines; compilations of all of the databases available around the, and also a new Roadmap that presents the different reimbursement structures in various regions and countries around the world. We also have information, reports, articles, on the various outputs from our special interest groups and task forces such as the Health Technology Assessment and Evidence Based Decisions, and the Good Research Practices on Retrospective Databases, Medication Compliance and Drug Standards. At our recent ISPOR Leadership Retreat we went through all the special interest groups, task forces, and various committees and used the ISPOR website as our guide throughout the day. So again, I encourage all of you to recognize the true depth and value of the resources and information that are contained within our own ISPOR website.

Publications. Again, this is the primary tool for us to communicate and disseminate the science and current research to our membership and our colleagues around the world. Specifically ISPOR CONNECTIONS; this journal has really progressed over the last few years to provide our membership with technical articles on methodology and health care policy issues. Value in Health continues to grow as an international peer reviewed journal. Our impact factor is 3.4 and is far ahead of most of other journals in our field. We also have Health Care Costs, Quality, and Outcomes: ISPOR Book of Terms, which has now been translated into many different languages to accommodate the growing local chapters. We have many other publications that are in development, and future books that are planned. Later in 2008 will be our book on medical device and diagnostic outcomes research in pharmacoeconomics and also future books that will be outputs of the various good research practice documents that have been published.

How does all of this get done? How do the meetings get organized? How do we get these good research practices, the publications, the outputs? It is all done by the working groups that are created through the membership of ISPOR. These working groups include our special interest groups, our ISPOR Task Forces, our ISPOR Advisory Councils, and also our student membership. We have over 200 students that are here at this meeting, which is really terrific. As you looked at the very large group at the student reception last night, we all need to recognize that these individuals are our future and we welcome them.

Where is ISPOR Going?
Let me take a moment to talk about the ISPOR vision. Remember that our vision is to assure that what we do is being utilized and applied by patients, providers, and payers. We also have a responsibility to continuously test the relevancy of our work, to those that we expect to benefit. I was able to participate in two important events during the last year that really helped to move our vision forward. The first was participation in a QALY workshop that was held in Philadelphia in November 2007. We had experts from around the world address the methodology of the QALY and also the application of the quality adjusted life year towards drug reimbursement decisions. The proceedings of this workshop are in development.  

I also was able to attend, along with our Founding Executive Director, Marilyn Dix Smith, a meeting of the Joint Commission of Pharmacy Practitioners. ISPOR is an invited participant to this group, and we were able to contribute the mission of our organization and what we do around outcomes measurements. We look forward to following up with a subset of this group, the Pharmacy Quality Alliance, to assist them in using outcomes measurement to determine the value of medication therapy management and other pharmacy interventions.

In summary of who we are, what we do, and where we are going, I'd like to take the opportunity to thank some of the key individuals that have assisted in making these many accomplishments happen, over the last year. First and foremost, it is a tremendous pleasure to give special thanks to the ISPOR staff. This is a tremendous organization of individuals that are truly responsible for the day to day activities to make our organization such a success. They are now 20 individuals strong. Our incoming President, Chris Pashos and I had the privilege of visiting them in February of 2008 in their offices in Lawrenceville, New Jersey. It is truly impressive to see how much activity goes on in those offices to support our organization.

I also would like to thank the faculty, staff, fellows, and students of our Pharmacotherapy Outcomes Research Center, Salt Lake City, Utah. The staff, for managing my travel and putting up with AM board teleconference calls, and the faculty, for being tolerant of my absence and absentmindedness when the multitasking got out of control. I would also like to thank the Dean of the College of Pharmacy, Dr. John Mauger for his ongoing support, and I am particularly pleased that he and his wife Karen are attending the 13th Annual International Meeting.

Thank you.


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