Why the ISPOR Institute Exists

Health is a right in law.
Yet for billions, it is not yet a reality.¹

Why Was the ISPOR Institute Created?

Where the Gap Shows Up

More than 140 countries guarantee the right to health in their constitutions.[1] Yet in 2023, about 4.6 billion people — more than half the world's population — still could not get the essential health services they needed.[2]

The distance between what governments have promised and what people actually receive shows up in 4 ways.

Accessible. A new technology reaches people in the wealthiest countries in about 2.7 years on average. In the poorest, it takes 8. That gap has barely narrowed in decades. [3]

Effective. In lower-income countries, an estimated 8 million people die each year after receiving poor-quality care — more than die from lack of access altogether.[4] Even in the United States, the world's highest-spending health system, an estimated 795,000 people die or are left permanently disabled each year from diagnostic errors.[5]

Efficient. The resources that do exist are not used well. Studies estimate that roughly one in five dollars spent on health is wasted — money that could be paying for care that saves lives. [6]

Affordable. For those who do get care, the cost can be ruinous. Health spending pushes about 1.6 billion people into poverty, or deeper into it, every year.[2]

These gaps are not only a failure of knowledge. Health systems around the world are under increasing pressure from funding cuts, service disruptions, technology innovations, growing complexity, and rising costs. At the same time, leaders in health are being asked to make increasingly higher-stakes decisions with limited resources under rapidly changing conditions. These pressures are exactly why the ISPOR Institute for Healthcare Transformation was created: to help health systems turn evidence into decisions that can succeed in the real world.

Healthcare systems do not improve simply because better evidence exists. Real transformation requires intentional collaboration and a clear goal to effect change. Many decisions impacting health fail not because the evidence is weak, but because implementation challenges were never fully considered. The ISPOR Institute focuses on helping stakeholders in health work through the structural, financial, political, and operational barriers that often prevent good decisions from leading to meaningful impact.

The ISPOR Institute for Healthcare Transformation was created by ISPOR, the leading global association for health economics and outcomes research (HEOR), to focus on how HEOR evidence and approaches can better translate into applications and outcomes that succeed in the real world. For people entrusted with improving health decisions globally, the ISPOR Institute is committed to discovering ways for HEOR evidence to have more impact.

We believe that by connecting evidence-producers and decision makers earlier, we increase the chances that they will identify the information that’s needed to make better healthcare decisions and be in a stronger position to implement those decisions successfully. Better decisions impacting health happen when researchers, payers, policy makers, clinicians, industry, patients, and communities come together to identify challenges and share perspectives.

Because the ISPOR Institute sits outside any single health system, sector, or national perspective, it is able to see connections and patterns that others may miss. Its work crosses boundaries between high- and low-income countries, public and private sectors, and health economics, policy, and practice. While others focus on generating evidence or making decisions, the ISPOR Institute looks at how the entire process — from evidence to real-world application — is working now in health systems throughout the world, and how it can work better.

How Does the ISPOR Institute Work?

The ISPOR Institute applies this role through a disciplined process that moves from problem definition to real-world application:

• Define the problem. The ISPOR Institute conducts analysis and structured stakeholder consultation over approximately 12 weeks to clarify the decision problem, identify where current approaches break down, and determine what evidence, process, or governance gap is limiting action.
• Co-create practical solutions. The ISPOR Institute convenes a focused workgroup of approximately 20 experts and decision makers to develop approaches that are practical, credible, and usable in real decision settings.
• Test, refine, and disseminate. Proposed solutions are tested in real-world environments or near-real decision settings. Results are used to refine the approach, document emerging practice, and share lessons for broader use. Depending on the topic, this stage may take 1 to 3 years.

The ISPOR Institute’s priorities focus on urgent decision making challenges facing health systems: improving equitable access to treatments and technologies; ensuring responsible integration of AI; grounding health decisions in real-world results; and setting patient-centered priorities in the face of spending constraints. In practice, these priorities often come together, as health systems make decisions that combine questions of access, evidence, affordability, implementation, and trust.

What Are Some Illustrative Applications for the ISPOR Institute?

• Making equity usable in health technology assessment (HTA) and healthcare decision making. Equity expectations are rising, but practical approaches remain unclear and unevenly applied. The ISPOR Institute can help clarify the equity concern at issue and test approaches that make equity more explicit, predictable, and usable in real decisions.
• Aligning living HTA, public financial management, and real-world evidence. Health systems often assess value, set budgets, and track outcomes through disconnected processes. The ISPOR Institute can help define the shared data, governance, and feedback systems needed to connect spending, delivery, and outcomes over time.
• Building a better way to value prevention. Preventive technologies often create long-term health and economic value that current priority-setting approaches do not fully capture. The ISPOR Institute can help develop and test approaches that reflect the value of prevention across time, budgets, and populations.
• Making global evidence usable in local decisions. Evidence generated in one setting may not fully reflect local populations, disease patterns, health-system capacity, or delivery conditions elsewhere. The ISPOR Institute can help design governed approaches for adapting existing evidence so decision makers can use it more confidently and appropriately in their own contexts.

Learn more about the ISPOR Institute for Healthcare Transformation:

References

[1] Yamin, Alicia Ely, Filho, Luciano Bottini & Malca, Camila Gianella (2024). Analysing governments' progress on the right to health. Bulletin of the World Health Organization, 102(5), 307 - 313. World Health Organization. https://doi.org/10.2471/BLT.23.290184

[2] World Bank, World Health Organization. (2025). Tracking Universal Health Coverage: 2025 Global Monitoring Report. Geneva: World Health Organization and the International Bank for Reconstruction and Development / The World Bank.

[3] Low- And Middle-Income Countries Experienced Delays Accessing New Essential Medicines, 1982–2024, Olivier J. Wouters and Jouni Kuha, Health Affairs 2024 43:10, 1410-1419 10.1377/hlthaff.2024.00089

[4] Kruk M, Gage A, Arsenault C et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution, The Lancet Global Health, 2018; 6, e1196-e1252

[5] Newman-Toker DE, Nassery N, Schaffer AC, et al, Burden of serious harms from diagnostic error in the USA, BMJ Quality & Safety 2024;33:109-120.

[6] OECD (2017), Tackling Wasteful Spending on Health, OECD Publishing, Paris, https://doi.org/10.1787/9789264266414-en