Outgoing Presidential Address

For those of you who don’t know Mandarin, that means welcome to Philadelphia to attend the 11th Annual International Meeting. I thought it appropriate to start in Chinese to highlight the fact that we recently had our very successful 2nd Asia-Pacific Meeting in Shanghai, China.

Thank you very much Joanna and good morning to all of you. I am delighted to welcome you to ISPOR’s 11th Annual Meeting, suitably in Philadelphia, where we had our very first meeting. And let me start with a few thank yous as well. First I want to thank you, Joanna, and your entire team for your hard work in putting together this year’s program. We have a fantastic meeting here in Philadelphia and we want to thank you very much for all of your efforts. Of course, meetings like this are also the result of a lot of hard work by the wonderful, talented, hard working ISPOR staff led by Marilyn Dix Smith and thanks to all of you as well.

This is an exciting time for ISPOR. It is a time of growth and accomplishment. We have a strong Society. We can be proud of many achievements. Most importantly, we have a diverse, energetic, engaged, and growing membership. Let me provide a few highlights from this past year. ISPOR membership continues to grow steadily. It now stands at over 3,000 members from 79 countries. Attendance at annual meetings has also risen sharply, in both the annual international meeting and the European meeting, with record attendance at our 2005 meeting in Florence and this year’s meeting in Philadelphia.

Last year I highlighted three priority areas for ISPOR that draw upon recommendations that emerged from the Vision 2010 Committee Report, and that continue upon themes that ISPOR has pursued for some time. These areas are excellence, internationalizing the organization, and communication and outreach. In terms of excellence, it is critical that we constantly strive to improve the quality of our Society, our annual meetings and Congresses, our journal, and the myriad of activities of our organization. I believe we are making good progress in our efforts. We launched an abstract quality assurance task force to evaluate the research abstract and selection process for the annual meeting. We will have a new committee to rethink and improve the annual meeting. And our journal, Value in Health, under the leadership of Josephine Mauskopf received the outstanding score of 3.657 impact factor leading all other journals in the health care services and health policy category.

The “I” in ISPOR stand, of course, for international. And ISPOR continues to expand its horizons. To justify that “I”, it is vital that we have a Society whose membership reflects the world’s population. I am pleased to say that we continue to expand our worldwide reach. Membership has grown in all regions and has been particularly strong in Europe and Asia. As Figure A shows, in 2000, 78% of members were from North America. By 2006, this had changed and you see in Figure B, the U.S. now accounts for 51% and other regions of the world are better represented, 33% in Europe, 6% in Asia, 2% in Russia, and so on. We now have local chapters in Hong Kong, Taiwan, Japan, China, Thailand, Brazil, Czech Republic, Poland, Russia, India, and Turkey. And chapters are in development in South Korea, Singapore, Malaysia, and Pakistan. We also have over 30 student chapters in 5 countries.

Our Second Asia-Pacific Conference in Shanghai in March of this year drew 750 attendees from all over the globe. The Shanghai conference underscored the dynamic nature of change in economic and health care systems in Asia. It also illustrated the fact that pharmacoeconomics and outcomes research, though still in its infancy in many countries, has emerged in a real way on the agendas of health policy makers across the region. The first day’s Plenary Session featured presentations by representatives from Pakistan, India, Thailand, Malaysia, Singapore, Korea, Japan, and China. Such a session would have been unimaginable a few years ago. Many presenters remarked on the fact that consideration of pharmacoeconomics and outcomes research is just beginning, that expertise is lacking, and that the systems to collect and report data are in need of improvement. However, it was also clear that significant strides are being made and most importantly, that the field has emerged on the radar screens of health officials. Perhaps most significantly of all, the conference in Shanghai has generated strong momentum for future growth in the region. The next three Asia-Pacific Meetings have just been announced and will take place in South Korea 2008, Thailand 2010, and Singapore 2012.

In terms of communication and outreach, we are moving forward as well. For the 2005 International Meeting, a public awareness initiative was implemented. Reviewers of abstracts now indicate whether the results of the study will contribute to the health care improvement of Society, whether the public should be made aware of the analysis. In the future we will use this information to identify and motivate abstract authors to prepare press releases. ISPOR and its journal, Value in Health, have begun issuing press releases on a regular basis. The ISPOR communications task force is working on ways to bridge the communications gap between the health policy community and health care decision makers. And in terms of additional outreach, we now have active Medical Device and Diagnostic Councils for North America, Europe, and Asia Pacific and we just launched a new council devoted to biotechnology.

We also continue to reach out to public and private payers who can benefit from our work. This is a longstanding priority for our Society. ISPOR has taken on a number of initiatives aimed at having a seat at the

table in policy discussions. A prime example is ISPOR’s response to the U.S. Medicare’s program draft guidance on coverage with evidence development. ISPOR was one of 65 organizations to provide comments on the draft guidance. We now have ongoing task forces on real world data, on budget impact analyses, on good research practices and costing of health technologies, and on the transferability of economic data and health technology assessment, all of which promise to help improve our field. I also know the future of ISPOR is in good hands with Mike Drummond, as the incoming President.

In thinking about the success of ISPOR, we can look at growth in membership, attendance at the annual meetings, and about our initiatives. But ultimately the success of ISPOR also means improving the health of the people behind all of our analyses and models, which brings me finally to a story. A little over a year ago, I was preparing for this meeting with a doctoral student of mine at Harvard named Fernando Culminaro. Fernando and I and some other colleagues, including Sean Sullivan of the University of Washington, John Watkins of Premier Health Plan, had analyzed the quality and completeness of the AMCP dossiers submitted to the Premier Health Plan. Fernando was the lead author on an abstract we submitted that was accepted as a poster for ISPOR’s May 2005 Annual International Meeting. In early May 2005, about two weeks before the ISPOR meeting, Fernando went to the doctor complaining of a cough, and came out with a diagnosis of lung cancer. This was a shock at every level.

He was a healthy 41-year-old who had never smoked. Fernando was also the dream of every faculty member: intelligent, hard working, conscientious, reliable, possessed of a great sense of humor -- the kind of person who puts everyone at ease. An MD from Argentina, Fernando also had 12 years experience in clinical pharmacology, before he came to Harvard to do a doctoral degree. He was a prized teaching assistant for key courses, and he won the Prestigious Novartis Fellowship Award. He was clearly a rising star. After his diagnosis, Fernando continued to work on the AMCP dossier project. It was very important to him. He traveled to Seattle to continue the field work and updated all of the analyses, even as his health declined. We submitted an abstract to this year’s meeting. It was accepted as a podium presentation for Tuesday morning.

During this past year, Fernando and I would meet regularly. He would tell me about all the fancy new drugs he was taking, for which he was very grateful. We would talk about whether the drugs were working. How did he know, what were his health outcomes? We talked about his quality of life. We talked about the cost of the drugs that he was on. “What is my cost per QALY” he would say with a laugh. In early April of this year he sent me a final set of analyses to present this year at the ISPOR meeting and apologized that he could not make the trip.

Everyone has his or her own Fernando story. And indeed all of our analyses, our models, our tables, our regressions, all of them have Fernandos behind them. Sometimes perhaps we forget this. Statistics are numbers with the tears dried off, is an old saying. The same might be said for all of our work. Our equations, our analyses, our simulations, the tears have been dried off. We can measure the success of our Society in different ways. We can measure it in terms of growth of membership, membership, growth in attendance at annual meetings, the number of abstracts submitted and workshops presented and all of our initiatives. And all of that is very, very important. But ultimately our work and our success are about improving the health of the people for the money we spend. Our success is really about that larger goal. And I believe that if we keep our eye on that goal, our Society will be strong for a long time to come.

So as I end my term as President, I want to remember Fernando, and all the Fernando’s behind our work, our Society is for them and really for everyone, including us, who are, or will be the statistics in our models. Our statistics, our models, our research, can truly help us live longer and healthier lives.

It has been a thrill and an honor for me to serve as President of this Society this past year. I look forward to serving ISPOR in other capacities in the future. I wish all of you a great stay in Philadelphia and a great, great meeting. Thank you very much.

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