Meeting round-up: ISPOR Annual 2021

Last month saw the second (and final?) virtual edition of ISPOR’s annual conference. If you’ve ever been to an ISPOR conference in real life, you’ll know that they’re massive. Try squishing that into your monitor, and you’ll get a reasonable idea of what the virtual incarnations are like. Generally speaking, ISPOR has got it figured out. They know how to run a virtual conference now. For the most part, things go smoothly. Stuff works.

In terms of value for money, there’s not much to complain about. ISPOR is not familiar with the idea of ‘less is more’. As a speaker, I paid $305 for the privilege of attending, for which I was (in principle) able to view more than 100 hours of content. The conference ran over four days, from 17th to 20th May, but there were also pre-release sessions, and recordings of all the live sessions can be watched until 30th June. All in all, there were 40-odd pre-release sessions, 50-odd live sessions, and a gazillion posters. It has taken me a while to publish this blog post because I had (hollow) intentions to watch more sessions before finishing it.

‘But is the content any good?’ I hear you cry. Well, the truth is, there is some filler. Mostly in the posters. There were too many posters. Probably over 1,000. And the platform for viewing them was not all that user-friendly. Perhaps, if you have very narrow interests, you can filter the posters to hone in on those you might like to see. I found myself doomscrolling through the whole lot. But there is more than enough high-quality content across the programme. More than I could consume.

So, in this blog post, I’ll just highlight a handful of sessions that I enjoyed. Some of these I watched live. Others, I watched on catch-up in the days that followed. For the benefit of anyone who paid to attend the conference, I will provide links [in brackets] to the recordings, which can be accessed until the end of June.

Let’s start with the plenaries. I often find that I do not enjoy plenaries. They tend to be light on novel content, with a bunch of important people uniting around anodyne ideas. But, hey! In a virtual setting, it’s much easier to walk out, so why not give it a try? There were three plenaries; one on health system resilience [P1], one on public health economics [P2], and one on new players in HEOR [P3]. I attended the first two, both heavily focussed on lessons learned from the COVID-19 pandemic. I started watching the third, but it wasn’t for me.

The plenary on health system resilience [P1] involved a far-reaching discussion about the role of HEOR in a world where people are rethinking almost everything about how we build policies and systems around the pharmaceutical industry. And I do mean world; Bernardo Mariano spoke from the WHO perspective, and Susann Roth spoke from the Asian Development Bank. The plenary featured that most rare and precious thing; disagreement. This was mostly thanks to an audience member asking about challenges to patent systems in the context of a pandemic. Bernardo argued that we couldn’t just accept patents-as-usual during a health emergency, while Kylie O’Keefe – somewhat inevitably – defended patents from an industry perspective.

That ISPOR bagged Anders Tegnell for the second plenary [P2] is impressive enough, but the other two speakers – Mairin Ryan and Meaghan Thumath – were both excellent. Anders provided a valuable perspective on policy responses to COVID in Sweden, while Meaghan focussed on intra- and international inequality in the impact of COVID, and Mairin spoke about keeping the HTA ship afloat in Ireland.

Various themes can be seen running through the conference sessions, with some linked to the topics covered in the plenaries. COVID was, of course, a big theme, with many sessions and posters addressing COVID-specific questions. I didn’t attend many of those but, still, COVID touched almost everything. In particular, there were several sessions on a ‘public health’ approach to HEOR or, more precisely, trying to understand the impacts of health care and health policies beyond individual patients. One standout session for me here was a spotlight session on modelling in public health [SP4]. Two economists presented their models for evaluating or forecasting the impact of COVID-19 policy responses. One presenter (Warwick McKibbin) kept describing the problem as complex and difficult, while the other (Martin Eichenbaum) kept using the word ‘simple’. Can you guess whose model was more convincing? Luckily, Anna Vassall was there to bring some interdisciplinary sense to the proceedings with some clear ambitions for the future of modelling public health emergencies.

Another key theme in the sessions that I attended was recent developments in HTA assessment policies. I particularly enjoyed a session that I watched on catch-up on the role of HTA in the US [SP3]. Darius Lakdawalla, Peter Neumann, and Gail Wilensky discussed their proposal to introduce a publicly-funded HTA body to the US. Imagine NICE, but with its teeth removed, one arm tied behind its back, and its eyes closed. But this would be progress for the US. If anyone knows how to make it happen, it’s this lot. All power to them!

At the same time as the session on HTA in the US was one on child QALYs [IP5]. In particular, whether they can be treated the same as adult QALYs. Led by Koonal Shah, it’s a question that’s been doing the rounds at conferences for a while now. But don’t expect it to be resolved any time soon. On a similar note was an excellent session on modifiers in HTA [IP11]. It included Pilar Pinilla from NICE and Steve Pearson from IfCaER (I will make this stick). They were both discussing their respective organisation’s developing approaches to weighting QALYs or cost-effectiveness thresholds. The session was brought together by my colleagues Martina Garau and Adrian Towse, supporting a good discussion that focussed on the tension between quantitative and deliberative approaches in HTA.

One issue panel did not seem to relate to any of the themes, and that was the panel that I organised [IP9] for more #DropDead discussion. Of course, it was a fantastic session, and I owe a lot of thanks to our moderator and panellists. Clashing with my own session – and which I am still hoping to get to on catch-up – was an issue panel on expert elicitation in the context of COVID [IP8]. There’s a ton of other stuff I’d like to watch, if only I can find the time.

Virtual conferences have their advantages. For starters, I can attend them all without killing myself or the planet. But, in general, I think they probably should (and will) cease to exist. They are exhausting. They demand almost as much mental input as an in-person conference, but you get none of the energy payback from the social interaction. There is simply no reason to cram the content of this conference into a week. It could be spread over a year. This is the future that I predict, and it will be a great thing. Societies like ISPOR will expand their online offering of webinars and the like throughout the year. We’ll have to get used to paying for them, either through membership fees or one-off ticket prices. In-person conferences will likely continue but will probably become smaller affairs. ISPOR may adopt a hybrid format in the future, and I’m very interested in seeing how that works.

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  • Founder of the Academic Health Economists' Blog. Principal Economist at the Office of Health Economics. ORCID: 0000-0001-9470-2369

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