 Eva Lydick PhD
2001- 2002 President
This is my first opportunity to address all the members of ISPOR. Last year I had the chance to talk to many of you individually and I would like to take this time to address what I heard as real concerns about the future direction of ISPOR. We have achieved remarkable growth in a few short years. For this we have to thank the hard work and dedication of the founders, the executive staff under Marilyn Dix Smith, and those individuals who have given of their time and efforts. But even this would not have been enough if there were not a clear need for a society like ISPOR. We all recognize that there are three dimensions to health care — quality, access, and affordability. You can have any two without much effort. The problem facing all societies is that they want all three for their members. This is what ISPOR is about — the trade-offs and compromises to maximize quality care, access to all, and affordability. These trade-offs are not easy and we don't operate in a simple arena. It is the complexity of the issues and the complexity of the realm in which we work that make ISPOR the fascinating organization it is. If we were one-dimensional and needed only to assess quality-of-care, we would have a different type of organization. If we were interested only in understanding health care costs, we would have another type of Society, but we have chosen a difficult task and we need individuals that are experts on the components of health care assessment (outcomes — clinical and patient-reported outcomes, quality-of-care measures, economics, increasing accessibility, and communicators) and those who can apply these findings to current situations.
When I walked around last year, I heard from many people who felt that the Society had taken a wrong turn. Some felt that there was an over-emphasis on academic standards and esoteric statistical analyses. Those tasked with influencing policy-makers were being held to a standard that would not play in the marketplace. Others felt that their Society would be better if the emphasis was a development and application of more rigorous quantitative tools. Still others wondered whether there was any role left for outcomes research or if outcomes meant nothing more than economics. I think the strength of ISPOR is that we have a mix of expertise and application. I would like to do my best to see that this mix remains. We have to have presentations on cutting-edge methodology and, yes, debates about the soundness of that methodology, but we also have to have applied studies (not examples generated as a showcase for methodology, but real studies with real results that can change and improve health care). We have to have studies that can be understood and appreciated by policy makers. We need the policy makers themselves as members so that we can better understand the world in which they work. We need all these groups and we need them talking to one another. That's what makes us different from some of our sister organizations. Not everyone is interested in developing new methodology. It takes time for new methodology to be applied generally by specialists in the field. It takes even more time for new methodologies and paradigms to be understood by those outside the specific field.
We need everyone. ISPOR has had amazing growth in the six years of its existence, but we still have a long way to go to get rigorous assessment of quality and costs systematically and consistently applied to health care assessment, and to make others understand that costs and cost-effectiveness are different. The idea is not to spend the least for health care, but to get the most value for what we do spend.
I've re-read the addresses from all the past presidents and there are two messages I took away. It is clear that ISPOR has grown and the challenges facing ISPOR, as an organization, have changed over the past six years. But it is also clear that the challenges that face our field have not changed nor have we made that much progress with these issues. Application of outcomes research and pharmacoeconomics to decision-making comes slowly — for a number of reasons — on the part of those performing outcomes research and pharmacoeconomics: lack of transparency and robustness of analyses, lack of hard data on alternative interventions and an over-reliance on modeling with reluctance to put conclusions to objective tests, and, on the part of decision-makers: suspicion of biased results, silo mentality, lack of understanding of methodology or even willingness to learn; and reluctance to make decisions on the basis of value.
Our biggest and most important initiative remains "Bridging the Gap" between those who perform pharmacoeconomics and outcomes research and those who are decision makers in health care. This initiative continues in many ways. We also have some new programs. I am delighted to be able to announce the creation of a lifetime achievement award in the area of outcomes research which we have received permission to call the Avedis Donabedian Award. As you would expect, this award is to honor individuals who have made a major contribution to the improvement of health outcomes. Any member of ISPOR can nominate an individual; nominees do NOT have to be a member of ISPOR. Nominations should be forwarded to Renee Arnold and are due by December 1st.
I am also pleased that Peter Neumann has agreed to chair the 2002 Annual Meeting. He is putting together his committee and we hope to have increased emphasis on outcomes research in this meeting. The ISPOR Newsletter has an exciting new look, thanks to new editor Steve Marx. Chris Pashos has agreed to shepherd a new version of the Lexicon. The task of compiling this Lexicon is formidable and we thank Chris for undertaking this, not once, but twice. I am also pleased that the call for volunteers to help resulted in a response from almost 200 members of ISPOR!
You may or may not be aware of the special interest groups (SIG); current active ones include quality-of-life, modeling, medical devices and managed care. These groups serve as forums and opportunities for members with similar interests to network, discuss issues of concern to them, and to provide insight and guidance to the board of directors on specific matters. If you don't see a SIG that interests you, consider forming one. We have six task forces charged with generating white papers on specific methodologic issues; this monumental effort guided by Bryan Luce is nearing completion. Five of these task forces presented at the Arlington meeting and these presentations will be reprised in Cannes at the European Congress later this year. As members of ISPOR, your comments are solicited and very much needed. And finally there are standing committees that always need active members.
Don't miss the opportunity within ISPOR to meet with others who share your views and don't miss the opportunities within ISPOR to meet others who have different viewpoints, different expertise, but similar goals.
I look forward to a productive year!
Sincerely,
Eva Lydick PhD
2001-02 ISPOR President
Messages from the
ISPOR Presidents
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