Messages from the ISPOR Presidents

Peter Davey MD, FRCP

Peter Davey MD, FRCP

2002-2003 ISPOR President


ISPOR is an incredibly active society and continues to grow. First, nearly 1200 people registered for the Annual International Meeting this year. Added to the 900 who attended the European Congress in November 2002, that means over 2000 people attended our meetings in the past year. Not content with that, we are holding our First Asia Pacific Conference in Kobe, Japan 1-3 September. Second, we now have 23 Student Chapters, nearly twice as many as this time last year. Third, we had four very well attended Special Interest Group (SIG) Forums at the Annual Meeting, where the SIGs set out their very ambitious plans for activity over the next year (check out the ISPOR website for more details). Finally our membership continues to grow and now stands over 2050 members.

So, plenty of activity, but is it taking us in the right direction? The ISPOR website hosts a document called ISPOR Vision 2005. Written in 1998 after the ISPOR Strategic Planning Retreat, the document sets out a vision for "a truly international multi-disciplinary professional membership society which advances/drives the policy, science, and practice of health outcomes research." Vision 2005 has some very specific suggestions for where we should be in 2005 and I am very pleased to report that in the last year we have taken several significant steps along the road.

Annual Meeting will continue to be THE HEALTH OUTCOMES event of the year.

Well, nearly 1200 people clearly think that the Annual Meeting is the place to be, but back in September 1998 ISPOR only had the Annual Meeting. The first European Congress in Cologne (November 1998) was still two months away. Attendance at the annual European meeting has more than doubled since 1998 and now we are taking ISPOR to Japan. On this one I think that ISPOR in 2003 is already way ahead of the Vision, not content with hosting THE Health Outcomes event of the year, we are holding THREE.

Educator

"ISPOR will offer an extensive and diverse series of educational tools and opportunities for the sector; the media for distance-based learning will be harnessed."

I announced the establishment of a Learning Outcomes Task Force in my first Fireside Chat, Lieven Annemans agreed to Chair the Task Force and we signed up a core group of 16 people at the Rotterdam Congress. When we asked you, the members, who would be interested, 160 people signed up. Not so much a Task Force, more an Armada. The Core Group is working on a first draft of a document defining the learning outcomes for Technical Skills and for Ethical, Social and Professional Skills for three levels of expertise (Awareness, Application and Conceptual) for six different audiences:

  1. Pharmaceutical Industry
  2. P&T Members responsible for evaluation of pharmacoeconomics and outcomes research
  3. Clinicians
  4. Outcomes Researchers
  5. Health Policy-makers/funders
  6. Health system Administration

We will share this first draft with the rest of the Task Force and aim to hold a meeting to develop case studies for learning and assessment in 2004.

second new initiative from ISPOR's Education Committee is the Internet Education Steering Committee, chaired by Tom Grapes with 9 additional members. The Steering Committee is working on an e-questionnaire for ISPOR members, so get ready to respond. This questionnaire will provide the Committee with information about demand with a second group to investigate supply, specifically identifying current Internet training programs in the area and determining if any certification programs are available.

Education is an integral part of the plans for two of the ISPOR SIGS: the Medication Compliance SIG (Education MDED Working Group co-chaired by Andrea Adamus and Hieu Tran) and the Managed Care_Pharmacy Benefit Management (MC_PBM) SIG (MC_PBM Working Group chaired by Jon Clouse). Both of these groups will work closely with the Education Committee and its Task Forces.

All of this activity builds on the established success of ISPOR's Short Courses, which continue to grow in scope, ambition, attendance, and quality.

Clearinghouse

ISPOR will assemble and disseminate all relevant reports of research and other relevant progress in the Health Outcomes field.

ISPOR's website is a great source of information about outcomes research. More importantly, it is being used; there were over a million hits in the month of April alone. Two of the SIGs have plans for exciting new features. The MC_PBM SIG Research Digest Working Group, chaired by Dennis Raisch, are working on a listing and systematic summary of managed care outcomes research papers for the ISPOR website. They are already well into their initial identification and review of original research articles from NLM Gateway and aim to have the first version of the ISPOR Managed Care Research Digest database available in July 2003. The Bibliography Working Group of the Medication Compliance SIG is co-chaired by Jasmanda Wu and Christine Fay Amorosi. They already have a page on the ISPOR website where they will post their analysis of the literature in a total of seven bibliographies. This will allow the user to analyze by year, disease, costs, and implications and will also provide an overall review by John Urquhart.

ISPOR's Quality of Life (QoL) Special Interest Group have established a Population Health Working Group (chaired by Eva Lydick) who held their first meeting in May 2003. They agreed to assemble the sources of data and agencies developing and using summary population health measures as the first step towards bridging the gap between the development and use of these measures by policy makers. The QoL SIG also has an Analysis and Interpretation Working Group (chaired by Mike Friedman) who will develop a web-based digest of articles on issues such as best practice, dealing with missing data and common issues on interpretation. Finally the Values and Valuation Working Group (chaired by John Brazier) aims to create a web-based V&V Digest on the ISPOR website to identify the best methods of achieving valuation of QoL measures.

Another key issue for the future will be cross-cultural adaptation of outcomes research and the QoL SIG has established a Cross-Cultural and Translational Adaptation Working Group (chaired by Diane Wild).

Communicator/Disseminator

ISPOR will be seen as THE SOURCE for the most current and credible information about the field and its science. VALUE IN HEALTH will be seen as THE JOURNAL in which to see our science and will be widely read and referenced by constituents and target audiences.

In the highly competitive world of scientific medical journals, Value in Health editor-in-chief Jo Mauskopf and her team have done a magnificent job in soliciting editorials and commentary for each issue to keep the Journal on par with, and at times, ahead of the competition. The next target is to build on Value in Health's NLM listing by getting it included in the Science Citation Index by 2005. We all need to cite ViH articles in our papers in order to start from as high a base as possible.

Value in Health is the flagship but we should not forget all of the other work that ISPOR does on communication through the excellent website and of course ISPOR Connections.

Researcher

ISPOR will fund (or coordinate the funding), commission, and on occasion actually conduct research, particularly when no single interest or funder can achieve the task and there is consensus on the need for answers with an emphasis on continual improvement of methodology.

The MC_PBM SIG has a Research Agenda Working Group, chaired by Peter Neumann and a Research Network Working Group, chaired by Barbara Edelman Lewis. The Research Agenda Working Group is planning a set of papers to review the application of the results of outcomes research in managed care from the perspectives of clinicians, industry, patients, health plans, employers, government and PBMs. Key issues will include trust, defining the state of the art by creating reference cases as templates for managed care and budget impact analysis and analysis of the use of research in benefit design. At the same time the Research Network Working Group will use an ISPOR member questionnaire to stimulate to encourage research collaboration and networking opportunities.

The ISPOR Board has included applications for external research funding as an explicit component in the job plan for the ISPOR Treasurer, who will take office in 2004.

Capacity-builder

ISPOR will identify and support (with resources and advocacy) centers of excellence to ensure a distributed capacity to train the next generation of outcomes researchers ...support faculty development and encourage, provide or oversee fellowships for individual training programs.

The Fellowship Task Force has already fostered successful internships and initiated ISPOR PRAP (Professional Recruitment Assistance Program), an increasingly high profile part of every ISPOR meeting and the website. The Website hosted 100 job advertisements last year and PRAP at the Annual Meeting facilitated 50 candidates to be interviewed for 16 positions. The work of the Learning Outcomes Task Force will achieve consensus about the skills that are essential to pharmacoeconomics and outcomes researchers in specific roles.

I started by mentioning the dramatic increase in Student Chapters as evidence of ISPOR's continued growth. Take a look at the Student Corner in this newsletter to find out more about their innovation over the past year, including their first Student Leadership Retreat, the creation of a Student Council, staging Mock Interviews at the Annual Meeting and forming a link with EPSA (European Pharmacy Students Association). We still only have one Student Chapter in Europe but that is going to change as Zeba Khan is now based in Basel, Switzerland with Novartis.

Credentialer

Quality assurance in the sector will be needed. ISPOR will develop and apply criteria for programs of excellence and professional career progression, including credentialing of personal incremental competency building. Membership may include a Fellows status for those fulfilling credentialed training or demonstrating such agreed competencies.

ISPOR started by putting its own house in order, including quality assurance as a key part of the ISPOR Short Courses by creating Short Course Development and Quality Assurance Task Forces for the Annual Meeting and European Congress. The Fellowship Task Force is investigating the feasibility and legality of credentialing, either of courses or of individuals. ISPOR could act as a portal for distance learning modules and we are already in discussions with the University of Minnesota College of Pharmacy to host their pharmacoeconomic courses.

ISPOR';s Health Sciences Committee's Task Forces have produced a Code of Ethics (chaired by Frank Palumbo) and three excellent papers on good research practice in modeling (chaired by Milt Weinstein), analysis of retrospective data (chaired by Brenda Motheral) and communicating the results of research to decision makers (chaired by Mike Drummond). Once again the SIGs are making important contributions: the Medication Compliance SIG has established an Analyses Standards Working Group, chaired by Michael Nichol and the Managed Care PBM SIG has a Research Language Working Group, chaired by Elinor Chumney. They will be working from a very solid base with the imminent publication of Healthcare Cost, Quality, and Outcomes: the ISPOR Book of Terms, which will replace the ISPOR Lexicon First Edition both in currency and scope. The co-editors (Marc Berger, Kerstin Bingefors, Edwin Hedbloom, Chris Pashos and George Torrance) have done a fantastic job together and the SIGs all contributed material, notably the QoL SIG Concepts and Definitions Working Group (chaired by Margaret Rothman). However, it was you the members who really made it possible, as over 200 ISPOR members contributed as authors and reviewers

Advocate

Compatible with all these roles, the need to be known as independent and credible, and the will of a membership association, ISPOR will advocate for progress in the field and enlightened public policies internationally to achieve this

ISPOR's international advocacy is well established in Europe, with Chapters in Poland and Russia and the ever-growing annual European meeting. Membership reflects ISPOR's increasingly international profile; 40% of our current members are from outside the USA and it cannot be long before that proportion exceeds 50%. For the first time we held the 2002 ISPOR Strategic Planning Retreat in Europe because half of the ISPOR leadership who attended the Retreat were based in Europe. Currently 14% of our members live outside Europe and North America and this proportion will grow following the ISPOR First Asia-Pacific Conference effort of the ISPOR Chinese Chapter and building on Eva Lydick's invited visit to China, hosted by the Chinese Ministry of Labor and Social Insurance.

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Marilyn Dix Smith represented ISPOR at the FDA on April 10 2003, providing comments on the FDA Concept Paper on Risk Management Programs and emphasizing the key importance of outcomes assessment in the development and evaluation of a risk management plan.

The Population Health Working Group aims to build links with the US National Center for Health Statistics, Centers for Disease Control, Statistics Canada, the World Health Organization, and the World Bank. To this end, the working group convened a 1-day workshop on Summary Measures of Population Health just prior to the Annual Meeting, with a focus on "Bridging the Gap" between developers of such measures and decision-makers responsible for allocation of resources on a community or population level.

Constituent Involvement

ISPOR is a membership organization and makes a strong commitment to extend its membership. By the year 2005, ISPOR will have more than 4000 members from more than 50 countries, with a balance including at least 20% of members each from among Academia, Practice, Industry, and Public and Private Decision-makers.

ISPOR's membership has nearly doubled since September 1998 (from 1200 to 2050) and we do have members in 56 countries with a very even balance (35% Industry, 30% Academia, 23% Practice & Government and 22% from Research Organizations). Getting 4000 members by 2005 is a tall order (anybody want to own up to setting that target?) However, what is important is our continued growth in terms of numbers, geographical spread, and range of disciplines.

ISPOR will have strategic alliances and partnering agreements with other leadership organizations in the field or with specialized health care organizations.

We have established a Strategic Outreach Committee, chaired by Mike Drummond to help us fulfill this part of the vision. We continue to have ad-hoc associations with other societies. For example, ISPOR co-sponsored a meeting with ISPE at the Royal College of Physicians of Edinburgh on "Drug Treatment: Maximizing Benefit and minimizing risk" on 14 April 2003. A full report of this meeting will be published in the Journal of the Royal College of Physicians and we will keep you informed about progress via the ISPOR website. AMCP (the Academy of Managed Care Pharmacy) now provides their Journal free to all US ISPOR members and we want to build stronger links with AMCP and their work on drug formularies.

The Future

The future lies with Sean Sullivan, our new President, and you can find out more from his Incoming Presidential Address in the next issue of ISPOR Connections. Sean has already established a Vision 2010 Committee, co-chaired by Marc Berger and Jerry Oster and you can keep up with their work on the ISPOR website. They aim to have a draft report ready by January 2004 with a final report ready for the 2004 AGM.

The ISPOR Board of Directors approved the Vision 2010 Committee in November 2002. At the same time we recognized the need to develop a plan for implementation of the ISPOR Vision 2005, through an ISPOR Vision Implementation Committee. This will be chaired by the Past-President and will include the immediate Past President as a member, which basically means that I will be continuing to work on this with Eva Lydick and Sean Sullivan over the next two years. We would like to hear from you about the ISPOR Vision 2005 and the work that has yet to be done. We are almost there in most of the key areas but I would identify three for further attention:

  1. Credentialing of individuals, courses, and institutions.
  2. ISPOR's role in conducting and communicating research.
  3. Extending ISPOR's influence on decision-making and on education outside the USA.

Messages from the ISPOR Presidents