Changing Top Trends in Health Economics and Operational Research

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ISPOR has published its third issue of the top trends in HEOR. Leela Barham takes a look at how the list has changed over time.

ISPOR has published its third issue of the top trends in HEOR. Leela Barham takes a look at how the list has changed over time.

The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is the self-proclaimed leading professional society for health economics and outcomes research globally. ISPOR’s 20,000 members span the world and its leaders1 include experts from academia, industry, consultancy, as well as those working in health technology assessment (HTA) agencies.  

In 2018 ISPOR began to identify the top 10 trends in health economics and outcomes research (HEOR); its latest top 10 trends for 2020 is published this month. So what’s rising and what’s falling? 

Table 1: ISPORs top 10 trends in HEOR, 2018, 2019 and 2020


Real-world evidence has emerged as the top issue for 2020 and was in the top 3 for 2019. Drug pricing is a consistent theme, moving from the number 1 slot in 2018 and 2019 but only to second position in 2020. Curative therapies have made a return to the top 10 in 2020, at number 3, after disappearing from 2019’s top 10, but being number 2 back in 2018.


What’s interesting to note too, aside from the top issues having some consistency, is how some topics have dropped off the chart. Issues including accelerated drug approvals, diagnostics, biosimilars, disruptive innovators, big data, value assessment frameworks, healthcare decision making for low-income countries and unhealthy behaviors are no longer explicitly named checked. 

Yet this is why it matters to recognize the linkages across the topics; precision medicine is linked to diagnostics, for example. Similarly, overall healthcare spending, a new topic for 2020, is linked to issues such as the use of biosimilars, which can come in at lower prices than their originator biologics (albeit recognizing that medicines spend is still only a small part of overall medicines spend). Plus, it’s hard to know if you’re doing a value-based contract unless you’ve agreed on what value is which is what value assessment frameworks try to do. 

It may also be partly to do with the evolution in terminology over time; this probably explains the move from mHealth to digital technologies for example. As long as the change is to help more clearly convey the concept, that’s all good. 

It’s likely, given the breadth and depth of ISPOR membership, that many of these top topics are exactly what payers want help on, so expect more from the ISPOR membership on how to respond to payer worries, which can also help companies to respond. 

And for those who (rightly) always ask about the patient, they are there too; real-world evidence does, after all, come from patients.

Leela Barham is a researcher and writer on health and pharmaceuticals from a health economic and policy perspective.