Advancing HEOR in Low- and Middle-Income Countries: How ISPOR Makes an Impact on Global Health
Robert Selby, MBA, Director, Global Networks, ISPOR, Lawrenceville, NJ, USA
ISPOR’s Strategic Plan 2024 affirms a strong commitment to support the core tenets of the Society’s mission even amid unprecedented challenges caused by the COVID-19 pandemic. The Society’s mission of improving healthcare decisions around the globe remains more critical than ever.
As part of the strategic plan priorities, the ISPOR Board of Directors acknowledged the elevation of advancement and utilization of health economics and outcomes research (HEOR) in low- and middle-income countries (LMICs).
Per the World Bank, LMICs are countries with gross national incomes (GNI) that range from $1045 or less (low income); $1046 to $4095 GNI per capita (lower-middle income); and $4096 to $12,695 GNI per capita (upper-middle income) (Figure 1). Many countries lack resources to invest adequately in healthcare spending and are more vulnerable to shocks posed by crises such as the global pandemic. At the same time, LMICs stand to benefit greatly from HEOR as they address issues of access and budget, among others.
Figure 1. Low- to middle-income countries classification defined by the World Bank (July 2021).
ISPOR Activities That Support LMICs
Since its early days, ISPOR has invested resources in advancing HEOR and supporting members working and residing in LMICs, allocating $2.7 million toward mission-focused initiatives and carrying through those investments into 2020 and beyond.
ISPOR’s portfolio of programs supporting LMICs includes complimentary memberships and fee-waived registrations and educational grants to enable selected member attendance at ISPOR events. To support the work of chapters, chapter educational funds are offered and complimentary educational webinars and publications, leadership training, and stakeholder roundtables (including patient, health technology assessment, and payer roundtables) are conducted. Activities organized by ISPOR global groups including regional consortia and networks and chapters also facilitate information sharing and capacity building (Table).
Table. ISPOR low- to middle-income countries programs.
ISPOR is also strongly committed to leadership development and scientific excellence recognition globally and has recently introduced the LMIC Health Economics and Outcomes Research Award to recognize individuals with demonstrated outstanding research achievements in HEOR in LMICs. This award helps to support and acknowledge outstanding HEOR work underway in LMICs. To learn more about ISPOR’s mission support programs for LMICs, please visit here.
These programs have had a direct impact on ISPOR’s mission to improve health globally by providing key opportunities for professionals to share their research and interact with fellow experts to further their careers, fostering inclusivity and diversity of thought within the HEOR profession. LMIC investments further allow HEOR to thrive in emerging regions by building capacity and awareness within the specific countries. These efforts also indirectly support countries in the development of their health systems and economies to improve resource prioritization, access to health technologies, investment and innovation, and opportunities for growth to improve health outcomes and standards of living.
These efforts, coupled with the growing need for HEOR globally, have ensured that individuals from LMICs make significant contribution to major ISPOR initiatives (Figure 2).
Figure 2. Contribution to ISPOR initiatives by individuals from low- to middle-income countries (LMICs).
ISPOR regional chapters and members demonstrated a significant impact on global health policy in 2020 through their activities:
• Chapter members in China participated in PE/HTA (pharmacoeconomic/health technology assessment) appraisal for the national health insurance negotiation with manufacturers and served on the PE Expert Panel to update the 2020 National Medical Insurance Medication List.
• In Malaysia, chapter members conducted a postpandemic COVID-19 analysis organized by the Academy of Science, Ministry of Science and Technology.
• In Thailand, key chapter members were included in an economic working group to support the selection of the National List of Essential Medicines of Thailand.
• In Ukraine, chapter members and national HEOR leaders have been involved the Ministry of Health’s HTA working group and participated in the development of HTA legislation. More examples of impact are listed in Figure 3.
Figure 3. ISPOR Regional chapter impact on health policy in 2020.
Raising Visibility and Impact: The ISPOR LMIC Initiative
While the success and impact of these programs is evident through these outcomes, it has also been acknowledged by ISPOR leaders and members that broad awareness of these programs and of their impact is lacking. This is an important consideration as ISPOR develops key performance indicators to objectively measure investments and their impact and success. Two separate ISPOR Board of Directors work groups recently affirmed that ISPOR groups and chapters are doing significant work and that more can be done to highlight results that may go unnoticed by the broader ISPOR membership.
To assess strategy and progress, the ISPOR Board of Directors appointed a special LMIC work group in early 2021 with the goals of (1) evaluating ISPOR’s impact in LMICs to achieve the mission to promote HEOR excellence to improve decision making for health globally; and (2) assessing the return on current investments and recommending adjustments to current plans, proposing strategies to best elevate ISPOR’s impact.
The results from the work group generated a final proposal for action:
• Develop a communication plan to share the academic and health policy impact of ISPOR in the LMICs
• Explore collaboration opportunities with select organizations on LMIC-related initiatives
• Articulate key performance indicators around measures of success for ISPOR LMIC programs
Looking to the future, program objectives will be balanced between 2 facets of impact—policy and academic—with an overall view to improving healthcare decision making. ISPOR will also develop a communication plan to share the impact of ISPOR’s LMIC program within the ISPOR membership and the broader HEOR and healthcare community. As part of the communication plan, impact stories and testimonials from key membership demographics will be collected to spotlight the impact that ISPOR has had on the community from a member perspective. Finally, ISPOR will explore collaboration opportunities with select organizations on some LMIC-related initiatives. Key ISPOR leadership groups, including the LMIC work group and global councils, will be working with ISPOR staff through 2022 and beyond to implement these proposal objectives.
We Welcome Your Input!
As ISPOR looks to capture the member story and illustrate the great progress and influence being made at the local level, we encourage you to share your stories of impact with us and describe how ISPOR has helped to advance your career and the field of HEOR in your country. As part of the rich tapestry that is our ISPOR membership community, you are integral to the success of our mission.
We encourage you to get actively involved in our global initiatives, even if you are not from the LMIC regions. Contact globalnetworks@ispor.org to learn more.
