Twenty-Five Years of Health Economics and Outcomes Research: An Exploration of Value in Health
Abstract
Introduction
This year marks the 25th anniversary of Value in Health. Since its inaugural issue in May 1998, the journal has seen significant increases in the number of submissions, downloads (a measure of frequency that manuscripts are read), and citations. The impact factor has also increased. As a result, Value in Health has emerged as one of the top-ranked journals in the field of health economics and outcomes research (HEOR). In this article, we mark the 25th anniversary of the journal by examining the changes in the growth and composition of the literature and highlighting some of the key articles from the 25 top-cited items that the journal has published.
In an article published in the third issue of the journal, Joel Hay and Richard Ernst, the inaugural Editor-in-Chief and Scientific Editor, set out a vision for what they hoped the journal would achieve.1
They noted that “Pharmacoeconomics is still a new field, one that has grown rapidly because its core subject, cost-effectiveness analysis, is easy to apply and has powerful applications for healthcare decision making….” Nevertheless, they also argued that “the theoretical foundations of pharmacoeconomics and health outcomes analysis are weak compared with those in the related behavioral sciences.” Therefore, a major consequence was that “Research in this field is this often viewed with skepticism regarding bias—or its appearance—in research methods, results, and conclusions. A major goal of Value in Health is to serve as a forum where consensus can be built around development of guidelines for conducting and reporting research in the field.” To what extent has the content published in Value in Health contributed to achieving this goal?
Growth and Composition of the Literature
Table 1 shows that the number of articles published by Value in Health increased from approximately 58 per year in the period from 1998 to 2010 to approximately 196 per year in the period 2019 to 2022. Since 2011, the articles have been categorized by research type or focus. Economic evaluations have consistently formed the largest group, but in recent years the most rapidly growing groups numerically have been articles featuring methodological issues, health policy analyses, and systematic literature reviews. The other major change has been the publication of articles in themed sections. These articles focus on a particular topic and normally contain a mix of articles in all categories. In addition, since 2011 the journal has published more than 60 ISPOR Reports. These are articles written by official ISPOR member groups and are predominantly Good Practices Reports discussing methodological issues in HEOR. The first task force report was published in 2003, so some are also included in the pre-2011 total.
Most Highly Cited Items
As noted earlier, a major feature of the content of Value in Health over the years has been the Good Practices Reports of ISPOR task force groups. Many of these are among the top 25 most cited items. The Good Practices Reports contribute directly to the goal outlined by the founding editors, in that they review the existing research in a particular field of HEOR and then propose guidelines for good practice in the conduct and/or reporting of that research.
Good Practices Reports have been published in all the major topic areas in the journal’s scope. In the field of patient-reported outcome (PRO) measures, top-cited reports have covered topics such as the translation and cultural adaptation of PRO measures2 and the content validity of PRO measures.3,4 In the field of economic evaluation, the top-cited reports deal with the reporting of economic evaluations,5,6 decision-analytic modeling,7,8 budget impact analysis,9,10 and cost-effectiveness assessment alongside clinical trials.11,12 In the field of preference-based assessments, there have been 3 top-cited reports on the development and use of conjoint analysis, in particular discrete choice experiments.13, 14, 15 Finally, in the field of comparative effectiveness research and health technology assessment, the top-cited reports were those on indirect treatment comparisons and network meta-analysis16,17 and on using real-world evidence for coverage decisions.18
Many of the other top-cited articles also discuss important issues in the conduct and reporting of HEOR. Two contributions from one of ISPOR’s special interest groups discuss the definition and classification of measures of adherence and persistence.19,20 In the field of PRO measures, Matza et al21 discuss the assessment of health-related quality of life in children, Gwaltney et al22 discuss the equivalence of electronic and pen-and-paper administration, and Acquadro et al23 discuss methods for translating health-related quality of life questionnaires for use in multinational clinical trials. Bridging the fields of economic evaluation and health policy, Eichler et al24 discuss the use of cost-effectiveness thresholds in healthcare decision making. Finally, in the field of preference-based measures, van Hout et al25 discuss an algorithm for mapping the new 5-level version of EQ-5D measure onto the existing 3-level version of EQ-5D value sets, and Versteegh et al26 discuss the derivation of the Dutch tariff (value set) for the 5-level version of EQ-5D.
Therefore, when considering the top-cited items as a group, it does seem that a major focus of Value in Health has been on improving the conduct and reporting of HEOR studies and on developing good practice guidelines, consistent with the goal set by the founding editors of the journal.
Value in Health Going Forward
As the current Editors-in-Chief, we are committed to continuing to advance HEOR science and methods. At the same time, we hope that the advancement in scientific rigor will also motivate even greater acceptance by payers, prescribers, and policy makers of those HEOR articles that apply best practices of HEOR methods to address real-world decision making. In turn, this will influence which evidence-based drugs and health technologies are accessed by patients and the public. As that occurs, both Value in Health and the field of HEOR will achieve the potential of improving global public health, extending life, and improving health-related quality of life.
We are also committed to identifying critical gaps in the theoretical and applied HEOR literature and issuing calls for manuscripts for themed sections that address those gaps. Although some of those themes will emerge in concert with ISPOR’s Health Science Policy Council, we also will work with our associate editors and listen to what ISPOR members and the broader HEOR community to identify important HEOR themes. We may also introduce new categories of articles or edit how we categorize sections of Value in Health as HEOR continues to evolve. Authors should never feel compelled to align with the specific calls associated with themed sections. All submissions that align with our Instructions for Authors and represent novel contributions will always be considered for publication in Value in Health.
Authors
Michael F. Drummond C. Daniel Mullins