Messages from the ISPOR Presidents

Chris L. Pashos PhD

Chris L. Pashos PhD

2008-2009 ISPOR President
Vice Pres & Executive Director of HERQuLES, Abt Bio-Pharma Solutions, Inc.,
Lexington, MA, USA

It was an honor and privilege for me to welcome more than 2,000 ISPOR members to Orlando for the ISPOR 14th Annual International Meeting. Across the street was SeaWorld, home of Shamu, the killer whale and other wondrous underwater beings. Down the road was Disney World, with Mickey Mouse and friends. There in the Renaissance Hotel, we had ISPOR World, with its informative short courses, thought-provoking plenary sessions and so many research presentations, workshops, issue panels, educational symposia.

People come to Orlando every day of the year from all over the world to enjoy its theme parks because they creatively open up worlds that we do not typically see in our more mundane lives. Our Meeting participants took time out of very busy schedules to actively participate in this important conference. I hope that the many interactions with colleagues took all of us for a brief period out of the daily grind to perhaps a higher endorphine-filled level – with plenty of opportunities to share aspects of our research methods and findings, policy making processes, and clinical practice decision making.

I have been asked, “Why did we meet in Orlando?” After all, does not the International Society for Pharmacoeconomics and Outcomes Research typically meet in the world’s capitals – Washington, Athens, Paris, Seoul, or centers of health care delivery and research – Philadelphia, Shanghai, Barcelona?

Actually, this year in 2009, it seems very fitting that we met in Orlando. Those of us who flew to Orlando undoubtedly shared the airplane with families or groups of friends coming to enjoy the attractions for which Orlando is famous around the world. It is these people for whom our work ultimately applies and is important –whether we are researchers, government or private policy-makers or health technology manufacturers. As we debate the validity of a study, the value of a methodology, the worth of a heath care technology, or the usefulness of alternative health care reforms, let us always consider the ultimate beneficiaries or recipients of our policies, or studies, or health care technologies – the patients.

Our 14th Annual International Meeting came at an auspicious time. Government and private policy makers are increasingly thinking about that intersection of health care and economics. The United States is in the midst of another attempt to reform its health care system. The last major US national attempt for reform was in 1993 and 1994, before ISPOR had been created. In contrast to that reform effort, multiple organization types have suggested that they believe that the need for change is real, and the time for change is right. As a result and with political leadership, these multiple stakeholder types are at the table discussing what can and should be done. The President’s recent meetings at the White House with a variety of leaders were an important signal of this.

The United States is not alone. Premier Wen Jiabao of China announced earlier this year key aspects of health care reform for the globe’s most populous nation. It seems that specific steps will be taken toward an “essential drugs list” which will affect health care technology pricing and reimbursement, and have potentially broad implications.

These examples in the United States and China are only a small representation of what is going on globally with respect to health care delivery and financing. These developments certainly affect our work, and in the days, months, and years ahead, our work will undoubtedly have an impact on these developments.

The ISPOR 14th Annual International Meeting acknowledged these important events. For the thought-provoking program of the Meeting, I extend our sincere gratitude to the program chair, Dr. John Hornberger of CEDAR Associates and the Stanford University School of Medicine. Tirelessly, Dr. Hornberger worked to create a timely, relevant series of plenary sessions that should inspire us as we move forward in this exciting time in our field. Also, we thank him and his very capable team on the Program Planning Committee for the solid line-up of research presentations, issue panels, workshops and other features of the Meeting.

Note that the Planning Committee is comprised of physicians, pharmacists, economists, psychometricians, statisticians, individuals from many disciplines and with many different perspectives. A key strength of ISPOR is a key value of our field, our inclusiveness, our openness to those of different perspectives.

As the membership has grown, it is interesting to note that the representation by work environment, on a percentage basis, has remained consistent over several years. For example, currently, of our 4,500 members, 39% work in health care technology companies, 26% in academia, 21% in research organizations, and 13% in health care provider organizations and governmental agencies. In the year 2000, of our Society’s 1,600 members, these proportions were practically the same: 37% in health care technology companies, 26% in academia, 26% in research organizations, and 12% in health care provider organizations and governmental agencies. Thus, as our membership has grown overall during recent years, so has the membership specifically from each of the different types of organizations who conduct and use pharmacoeconomics and outcomes research.

As is evident at the ISPOR 14th Annual International Meeting, we do not work in isolation, whether by research specialty, work environment or geographic region. We neither are, nor should be, isolated in silos. Instead we are all interlocking and interdependent pieces of a single dynamic. Only by bridging those perspectives will our own countries be better able to overcome the challenges we face with respect to providing access to appropriate health care to optimize societal outcomes. ISPOR and its leadership and members take seriously the obligation to reach out to different constituencies, to share with and to learn from each other. The 14th International Meeting provides us with one such opportunity.

Each year ISPOR welcomes us to the biggest meeting ever. This year our ability to say this is so significant, especially given the world economy, restrictions on travel either due to financial constraints or to the swine flu outbreak. This Meeting and other major congresses are critical venues for ISPOR members. All of us – health care providers, policymakers, researchers and students – are able to share and learn about advancements in methods and applications. The increasing attendance at these meetings, as well as their expanding programs, attest to the role they play in helping ISPOR to achieve its mission and its vision to move the field forward.

BUT, as valuable as the meetings are for our Society’s members, they are perhaps MORE important for their role in motivating all of us who are members and giving us the information and contacts to advance the field in our communities far away from the specific conference venues. Outreach is the key word. In this regard, please reflect on our Society’s truly global expansion. ISPOR’s members come from 89 countries! Our membership has more than doubled in only five years! In fact, when the members of our Regional Chapters are added to our overall Society membership, we total nearly 7,500 in total, about triple our size in 2004.

The Society’s attention to geographic growth and increasing geographic coverage has coincided with the expanding number of geographically-defined Regional Chapters. Just recently, new Regional Chapters have been approved for Pakistan and Malaysia. Similarly, the increasing recognition of our field as an important scientific discipline is exemplified by the growth of our Student Chapters around the world. We currently have 42 Student Chapters and 576 Student Members. The three newest chapters have been formed in Asia, Europe and North America – representing China Pharmaceutical University, Charles University (Prague), and the University of Mississippi.

Recognizing the importance of our students as the “present” as well as the “future” of our Society, and of our field in general, the ISPOR Board of Directors recently approved the creation of a Student Chapter Faculty Advisor Council, which met face to face for the first time at this Meeting. The Council’s mission is to facilitate continuity and growth of the Student Chapters and to serve as a forum for the Faculty Advisors to network, especially to share information on issues and activities that can contribute to the success of the Student Chapters.

What is most remarkable is the role that ISPOR members are playing throughout their countries and communities to advance the field of pharmacoeconomics and outcomes research, elevate the rigor of the science, and advance its societal relevance and value. Scientific rigor and societal relevance, or (SR)2 are the cornerstones on which the success of our Society are based.

To that end, in much of what the Society is doing, it seems that we are guided by three important words that begin with the letter, “C”.

First, COLLABORATION – our work is typically done bringing together different perspectives and disciplines to meet the challenges we face, acknowledging that there is no single method or database or discipline that has all the answers.

Second, COLLEGIALITY- our work is typically done with respect toward these different perspectives and disciplines.

Third, COMMUNICATION – our work is not complete until we have shared findings and issues with others – think of the circles – other researchers, health care practitioners, decision-makers and policy-makers, and ultimately has an impact on patients.

The leaders of ISPOR at the International Meeting and around the world work hard to bring together these constituencies to better understand the nature of the challenges faced by their respective countries, to try to bridge their different perspectives, and ultimately to achieve better national outcomes. Sharp debate and disagreement may result, but only out of discussion and interaction can meaningful progress result in moving our field forward.

In terms of taking pharmacoeconomics and outcomes research to the people, nothing can compare with the Auto Rally initiated by the Russian Society, led by its president Dr. Pavel Vorobyev, executive director Dr. Oleg Borisenko, and colleagues. The Society’s Auto Rally in 2008 was an automobile caravan that departed Moscow and traveled the breadth of the largest country on earth ending in Baikal, in southeastern Siberia, a month later. In this innovative and creative undertaking, Professor Vorobyev brought the messages of evidence-based medicine and clinical-economic analysis to practicing physicians, government officials, patients’ delegates, and the media across Russia. This outreach is scheduled for an encore in 2009, again beginning in Moscow, but this time ending on the coast of the Pacific Ocean.

Another example of ISPOR outreach comes from the China Chapter. Led by its president, Dr. Shanlian Hu, ISPOR members in China are conducting a series of training courses for continuing medical education of community doctors. Within this program, hundreds of physicians are being trained in provinces all around the country, most notably in Zhejiang province, in which more than 700 physicians have been introduced to our field.

Many ISPOR chapters have run local, national and international seminars, schools and conferences. Among our new chapters, ISPOR Serbia, led by Vladimir Zah, held its first international conference focusing on what lessons in applying health economics to the delivery and financing of health care had been learned throughout central, eastern and southern Europe that could be applied to Serbia. Among those attending were leaders in government health and insurance agencies as well as academic and health care provider organizations.

Focusing on national policy-making, ISPOR members have played and are playing constructive roles in events that have led to the creation or revision of national guidelines. ISPOR members have been especially prominent in this area, from Mexico to South Korea to Thailand to just this month, in the Czech Republic, and elsewhere.

Meetings of all types, whether conferences, seminars, symposia, or courses, provide opportunity for ISPOR members to bring pharmacoeconomics and outcomes research to a broader audience. Overall, ISPOR’s meetings reflect well on what ISPOR has become – a global voice focused on advancing the science and expanding the use of pharmacoeconomics and outcomes research to serve the public health. The ISPOR 11th Annual European Congress in Athens, Greece and the ISPOR 3rd Asia-Pacific Conference in Seoul, South Korea, as well as the upcoming ISPOR 2nd Latin America Conference in Rio de Janeiro, Brazil and ISPOR 12th European Congress in Paris France, provide us with opportunities to meet to discuss and debate what our needs are and will be, and how we can move forward collaboratively to address them as efficiently and effectively as possible.

As well, ISPOR members are using other means to bring pharmacoeconomics and outcomes research to a broader audience. Publishing either journals or books in the local language is another major initiative for many of ISPOR’s members. Journals covering pharmacoeconomics have been created by ISPOR members in Czech Republic, Greece, Russia, and other countries. The book, Health Care Cost, Quality and Outcomes: ISPOR Book of Terms, is being published or soon will be in several languages, including Croatian, Japanese, Portuguese (Brazil), Russian, and Slovakian. As well, ISPOR Chapter websites have been launched or significantly upgraded by members in a variety of countries, including Hungary, Jordan, Russia, and Serbia.

Recognizing the need for greater public awareness of pharmacoeconomics and outcomes research, various ISPOR members have been attentive to media opportunities. For example, the ISPOR Israel chapter, led by its president, Dr. Dan Greenberg, had substantial coverage of its annual conference, focused on the value of anti-cancer drugs. Media coverage obtained through the initiative of ISPOR members produced articles in one of the country’s largest daily newspapers and in journals distributed to physicians and pharmacists.

These outreach efforts are expanding the number of those interested in our field beyond the original universities and capital cities. Some of our country-focused chapters are even creating local chapters. For example, within Colombia, plans are for chapters in all the major cities.

As members of the predominant professional society focused across the breadth of health care outcomes – clinical, economic, and patient-reported - I invite you to take advantage of the opportunities that ISPOR’s meetings offer to share and interact with your colleagues from around the world. More importantly, I invite you to share this knowledge and understanding with your organizations and your communities, so that together we can conscientiously continue to expand the science & application of pharmacoeconomics & outcomes research.

All of the examples of outreach above should motivate us to keep talking, not just to or with ourselves, but with our communities, participating in the national and local debates central to the delivery and financing of care. I want to thank all of you for the opportunity to serve you as President of the Society, and for all the creative and innovative ideas that you have shared to keep ISPOR moving forward. Keeping the Society at the forefront of our field with due attention to top quality and professionalism is such a monumental task. In this regard, it has been an honor and a privilege to work with many leaders of ISPOR, especially the Board of Directors: Diana Brixner, Michael Barry, Lou Garrison, Richard Willke, Karen Rascati, Shanlian Hu, Don Husereau, Zeba Khan, Paul Kind, and Penny Mohr. As well, there is no other Society Executive Director and no other Society staff that is as talented, organized and effective as Dr. Marilyn Dix Smith and our ISPOR support team. Thanks to all of you for all you do for all of us. Thank you for your hard work and wonderful contributions to ISPOR’s success.

As well, again remembering why we do what we do day in and day out, thanks to my family for support during this hectic year.

To all who are helping to build our field and move our Society forward, I extend my very best wishes.

Messages from the ISPOR Presidents