ISPOR Europe 2025 daily round-ups: Day 3

After Day 2’s Taste of Scotland reception, where attendees and exhibitors mingled over locally sourced dishes and a generous sampling of whisky, a few sore heads may have been spotted as Day 3 of ISPOR Europe 2025 got underway in Glasgow.

Hosted by ISPOR—The Professional Society for Health Economics and Outcomes Research, the conference continued under the theme “Powering Value and Access Through Patient-Centered Collaboration.” Over the past few days, we have been covering key sessions from the meeting — readers can find our roundups from Day 1 and Day 2. Now, we turn to the final day’s highlights, as the closing plenary brought the week’s discussions full circle, tying together themes of patient engagement, pragmatic evidence generation, and the evolving role of real-world data (RWD) in healthcare decision-making across Europe.

We hope our daily round-ups have offered readers valuable insights from the discussions taking place throughout the conference. Over the coming weeks, we will be sharing exclusive insights from key sessions at ISPOR Europe 2025, along with our Peek Behind the Poster interviews and post-event reflections. And for those wanting to catch up on the recorded sessions, ISPOR are offering a Digital Conference Pass, providing an opportunity to access all the content from Glasgow on demand.

Opening remarks and leadership updates

The closing session of ISPOR Europe 2025 brought together reflection, gratitude, and forward vision, encapsulating the Society’s ongoing commitment to evidence-based, patient-centered transformation in healthcare.

Rob Abbott (Chief Executive Officer, ISPOR, USA) opened with humor, comparing the meeting to “a marathon” and suggesting that delegates deserved “finisher T-shirts.” He honored ISPOR founder Marilyn Dix Smith and thanked the current ISPOR Board of Directors, as well as the Program Committee co-chairs, Maria Dutarte (EUPATI, the Netherlands), Denise Lacombe (EORTC, Belgium), and Joep Muijrers (Gilde Healthcare Partners, the Netherlands), for their leadership in shaping a conference that was “more than the sum of its parts.” Abbott reiterated ISPOR’s enduring commitment to patient centricity, describing the conference’s patient track as “a point on the way” in a continuing journey to embed the patient voice at every level of evidence generation and decision-making. Every element of HEOR, he said, ultimately serves the patient. It is when patients and their families experience illness that ISPOR’s community stands at the coalface of healthcare, translating evidence into real-world impact.

Laura Pizzi (Chief Science Officer, ISPOR, USA) followed with a science update, reminding delegates that “science, rigor, and evidence” remain the foundation of effective policy. She noted that the landscape of HEOR is shifting rapidly, with the future defined by living assessments, system-level evaluation, transparency, contextualized evidence, global standards, and expanding expertise. Pizzi highlighted three current priorities: advancing the science of value toward whole health, strengthening real-world evidence (RWE) and AI applications, and establishing ISPOR’s new health policy function. She also previewed the forthcoming Top 10 Trends 2026–2027 Report and an updated Science Strategy, described as ISPOR’s “North Star” for guiding future scientific priorities.

Encouraging delegates to stay actively engaged, Pizzi compelled them to join a Special Interest Group (SIG), volunteer as a reviewer for ISPOR task force reports, or participate in the new online Policy Community of Interest. “We need you to get involved,” she said, emphasizing that collaboration and open exchange are essential to overcoming distrust and strengthening the global HEOR community.

Joining Pizzi, Maarten Ijzerman (Erasmus University, the Netherlands) explored ISPOR’s key strategies, whole health and environmental sustainability, citing hospitals’ carbon footprints and urging members to join ISPOR’s new Environmental Assessment in HEOR SIG.

Plenary 3: RWE in European healthcare decision-making—what's in it for patients?

The final plenary of ISPOR Europe 2025 reinforced that RWE can only fulfil its promise if it truly serves patients. While Europe now has the infrastructure to generate and analyze high-quality data, meaningful progress depends on trust, transparency and active patient involvement.

Moderated by Karen Facey (Universities of Oxford, Utrecht, Edinburgh and RWE4Decisions, the Netherlands), the panel brought together Maria Dutarte (European Patients’ Academy on Therapeutic Innovation [EUPATI], the Netherlands), Pall Jonsson (National Institute for Health and Care Excellence [NICE], UK), Sofie Gustafsson (Pfizer, Sweden) and Renske Los (Erasmus MC, the Netherlands) to discuss a shift from viewing patients as data subjects to partners in research design, evidence generation and policy development. As the European Health Data Space and other initiatives advance, collaboration across regulators, industry, academia and patients will be essential to ensure that RWE both informs decisions and offers genuine benefit to patients.

Read our in-depth summary of Plenary 3 here >>>

Concurrent sessions

Issue Panel: Europe at crossroads: can it compete with other regions for healthcare innovation?

Moderated by Cristina Masseria (Aesara, Spain), the panel built on many of the themes from the Day 1 plenary, examining how policy uncertainty and global competition are reshaping investment in Europe. Masseria noted that investors seek return and certainty, particularly for forecasting, yet Europe’s share of global R&D is shrinking while China’s has risen from 1% in 2010 to 30% in 2020. She highlighted how drug launches increasingly begin in the US, with Europe falling behind both in innovation and in manufacturing investment. Complex healthcare systems, fragmented pricing, and reference pricing all contribute to uncertainty, while the introduction of the hotly discussed US most-favored-nation (MFN) policy adds further volatility.

Brian O’Rourke (Brian O’Rourke Health Care Consulting, Inc., Canada) reflected on his experience in HTA and payer systems, emphasizing that while the EU HTA Regulation (EU HTAR) represents a step forward through joint scientific consultations (JSCs) and joint clinical assessments (JCAs), Europe must go further. He called for harmonized methodologies, outcome-based contracting, and innovation in price negotiation. O’Rourke urged stakeholders to “supercharge” engagement with patients and clinicians throughout the lifecycle of medicines, ensuring that evidence generation and value assessment reflect real-world needs and perspectives, not only regulatory requirements.

Neal Masia (EntityRisk, Inc., USA) described MFN as “the most effective non-policy policy,” creating volatility and deterring investment by making European prices a potential liability for US revenues. He warned that this unpredictability, coupled with China’s expanding R&D capacity and supportive government policies, risks diverting innovation away from Europe.

Offering the industry perspective, Eelko den Breejen (Pfizer Global, the Netherlands) stressed that Europe’s fragmented access landscape and restrictive mindset hinder competitiveness. He called for stable, predictable, and innovation-rewarding policies, arguing that fostering long-term investment requires clarity of intent and willingness to value innovation at both EU and national levels.

In closing, Masseria urged Europe to modernize, harmonize access and value frameworks, and “make history again” by rebuilding investor confidence in its life sciences ecosystem.

Workshop: Beyond the QALY: alternatives in the US and implications for EU

This workshop examined emerging approaches to value assessment that move beyond the traditional quality-adjusted life year (QALY) metric. The session was moderated by Beth Devine (University of Washington, USA), who reviewed the origins of the QALY and its limitations, particularly its potential bias against populations such as the elderly, disabled or terminally ill. Devine noted that under the Patient Protection and Affordable Care Act, the QALY cannot be used in US federal decision-making, prompting the development of alternative frameworks.

Varun Ektare (Indence Research Private Limited, India) presented two such measures – expected value of life years gained (EVLYG) and health years in total (HYT) – and demonstrated how they differ from the QALY in practical scenarios, including late-stage oncology, chronic pain and pediatric gene therapy. While EVLYG removes quality-of-life weighting to address distributional inequities, HYT offers a more comprehensive measure by integrating both survival and quality-of-life improvements.

Anirban Basu (University of Washington, USA) discussed the generalized risk-adjusted cost-effectiveness (GRACE) framework, which adjusts for both risk and disease severity and provides a method to map EQ-5D utility weights to GRACE utilities. Basu emphasized that while these new approaches can better align with ethical and policy constraints in the US, they also raise questions for European HTA systems about comparability and value alignment across jurisdictions.

Workshop: Lost in a labyrinth: EMA and HTA create confusion around patient-centered evidence requirements in Europe

This workshop examined how differing European regulatory and HTA expectations shape the use of patient-reported outcomes (PROs) and health-related quality of life (HRQoL) evidence, and how JCAs may bring greater consistency. Moderator Katja Rudell (Kielo Research, UK) recapped the EMA CHMP position that “HRQL assessment is optional” with label claims granted only when improvement is shown across most dimensions and supported by validity, reliability and clinical relevance, as outlined in the EMA Reflection Paper on HRQL. She detailed current JCA expectations, including the need for clear conceptual frameworks, validated patient-reported outcome measures (PROMs), baseline values, and pre-specified responder definitions, citing the Guidance on Outcomes for Joint Clinical Assessments. Rudell noted that JCAs now cover oncology and advanced therapy medicinal products (ATMPs), and will expand to orphan drugs in 2028, and include all products after 2030.

From industry, Bryan Bennett (Jazz Pharma, UK) argued that full alignment between regulators and HTA bodies is neither necessary nor realistic. The EMA focuses on efficacy, safety and disease-specific clinical outcome assessments (COAs) within randomized controlled trials (RCTs), while HTA bodies prioritize utility and quality of life measures such as EQ-5D, longer-term and pragmatic data, and RWE. Case examples including dapagliflozin and nivolumab with ipilimumab illustrated differences in accepted measures and the impact of missing data. Bennett advised early cross-functional planning, joint or parallel advice, development of core outcome sets that meet both regulatory and HTA needs, and strong strategies to minimize missing data.

Closing the session, Olivier Chassany (Assistance Publique–Hôpitaux de Paris, France) highlighted the ongoing divergence between EMA and HTA perspectives and the challenges of interpreting small PRO effects. He urged applicants to apply the same methodological rigor to PROs as to other endpoints, ensuring justified concept selection, clear scoring and responder definitions, and transparent reporting of missing data. Referring to the IQWiG General Methods Version 7.0, he highlighted its relevance for assessing measurement validity and presentation standards. While JCAs will harmonize submission formats, he cautioned that small effects and inconsistent reporting will continue to complicate HTA evaluations.

Workshop: US-centric drug policies: how national interests are reshaping global innovation and access 

Moderated by Meng Li (Tufts Medical Center – Center for the Evaluation of Value and Risk in Health, USA), this panel examined how US drug pricing and trade policies, particularly the evolving MFN executive order and proposed pharmaceutical tariffs, are influencing global dynamics in innovation and access. Li outlined how the US, accounting for more than half of global pharmaceutical sales, continues to shape investment incentives and market behavior worldwide. Changes in US policy, she noted, ripple far beyond its borders, affecting both affordability and the pace of R&D.

Bringing the patient voice, Gunnar Esiason (Boomer Esiason Foundation, USA) discussed the pharmaceutical industry’s reputational challenges and shared his experience living with cystic fibrosis. He cautioned that while cash-pay and direct-to-consumer approaches under MFN could improve transparency for some patients, they are unlikely to meet the needs of those with rare or high-cost conditions.

From an investor standpoint, Richard Xie (RA Capital Management, USA) used Net Present Value modeling to illustrate how pricing reforms such as MFN and the Inflation Reduction Act could reshape investment decisions. He showed that, when benchmarked against reduced US revenues, the financial returns on new drug programs decline sharply, leading to delayed or restricted global launches and fewer high-risk R&D investments. Xie warned that without stable policy environments, capital may shift away from biopharmaceutical innovation entirely, narrowing patient access to future therapies.

Turning the discussion to low- and middle-income countries (LMICs), Mikkel Oestergaard (MSD Innovation & Development GmbH, Switzerland) proposed a bottom-up global differential pricing framework built around health opportunity costs and strengthened local HTA capacity. He argued that sustainable access depends on aligning pricing models with each country’s health system priorities and budget constraints rather than imposing top-down rules. Oestergaard highlighted the need for hybrid solutions that combine local value assessment with international collaboration, ensuring that affordability efforts do not undermine incentives for innovation. He pointed to ongoing work by the ISPOR Global Access to Medical Innovation (GAMI) SIG to explore how such frameworks could function in practice, particularly in LMICs.

Speaking from the audience, Louis Garrison (University of Washington, USA) underscored the need for global cooperation to address inequities in access, describing delayed medicine availability as one of the “giant failures in our giant, complex ecosystem.”

Building on earlier conference sessions on affordability, investment, and value frameworks, this panel highlighted the growing urgency of aligning national interests with sustainable global innovation and equitable access.

Issue Panel: Battle of the bots: navigating the landscape of AI-enabled systematic literature review platforms

This highly attended issue panel tackled the rapidly evolving world of AI-assisted evidence synthesis, offering attendees the opportunity to hear a selection of vendors discuss the challenges of transparency, validation and real-world application. Moderated by Ramiro Gilardino (Independent, Switzerland), the session brought together Angeline Dhas (MadeAi, USA), Ranita Tarchand (Nested Knowledge, USA) and Mark Priatel (DistillerSR, Canada) for a discussion on how AI is reshaping systematic literature reviews (SLRs) and HTA workflows.

Gilardino set the stage by noting the growth of AI tools in HEOR and HTA – with an audience poll revealing that at least 40% were already using AI-assisted tools in their work.

Dhas described MadeAi’s multi-agent architecture and end-to-end platform for ongoing evidence monitoring, emphasizing usability, traceability and scalability. Tarchand outlined Nested Knowledge’s “human-in-the-loop” AI approach, sharing an example of a project with Certara (presented on Day 2 of ISPOR Europe), achieving time savings and high accuracy. Priatel discussed DistillerSR, including a recent partnership with Elsevier, and its future plans for greater agentic AI adoption and reproducibility controls.

Discussion centered on quality assurance, with all panelists underscoring the need for human oversight and transparency in inclusion decisions and data extraction. While AI excels at screening and scoping, interpretation and critical appraisal remain human domains.

The speakers concluded that selecting an AI-enabled SLR platform requires evaluating end-to-end functionality, validation transparency, scalability, and a foundation of trust – ensuring digital transformation enhances, rather than replaces, methodological rigor.

Issue Panel:  Embedding the patient voice within EU HTA: How can we balance inclusivity, representativeness, and scientific rigor?

Moderator Ruairi O'Donnell (Cencora, UK) opened by outlining the current status of the EU HTAR: that JCAs became live for oncology medicines in January 2025, the first JSC has been completed, and implementing acts for devices and diagnostics are advancing. He outlined how patients contribute by identifying experts, managing conflicts of interest, and providing input through interviews, written feedback, and review of scope proposals and draft reports.

Antonella Cardone (Cancer Patients Europe, Belgium) highlighted the importance of meaningful patient involvement, noting better communication but ongoing issues with short deadlines, limited feedback, and follow-up. Cancer Patients Europe’s June 2025 feedback called for earlier and systematic input from PICO (population, intervention, comparator, outcome) definition to final report, transparent feedback loops, stronger capacity-building, and use of plain language summaries. The organization is piloting earlier PICO input, organizational representation, and clearer guidance and tools to support systematic, “meaningful” engagement.

Justin Doan (Pfizer, USA) described a shift from ad hoc to structured, method-driven patient engagement embedded across PICO. He emphasized early co-design, pre-specification of key parameters such as minimal clinically important differences, responder definitions and PRO statistical analysis plans, transparent documentation, and the co-development of concise multilingual plain language summaries. The JSC case study showed how patient input led to added baseline PROs, predefined subgroups, use of core outcome sets, and better interpretability. He called for transparency on how patient feedback is used and for involving patients beyond PROs in study design and comparator discussions.

Matteo Scarabelli (EFPIA, Belgium) called for investment in patient training and recognition of patient and clinician input as evidence. He emphasized the need for clear selection criteria and a balanced approach to managing conflicts of interest (COIs) that values both transparency and expertise. He also highlighted the role of community advisory boards and the importance of flexible COI rules to enable their contribution. Scarabelli urged stronger partnerships with patient organizations and clear guidance building on EUnetHTA lessons to ensure systematic, equitable, and meaningful participation.

Our closing reflections from ISPOR Europe 2025

As ISPOR Europe 2025 comes to a close, the conversations in Glasgow have reinforced how essential collaboration, patient engagement, and RWE are shaping healthcare decision-making across Europe. From the opening plenary to the final reflections on data, access, and value, the meeting highlighted both the progress made and the work still ahead in building more connected, patient-centered systems. Amid a rapidly evolving policy landscape, and the rippling effects of global economic and regulatory shifts, these discussions made clear that the role of HEOR has never been more vital in guiding sustainable, evidence-based healthcare.

The Evidence Base team would like to thank ISPOR for once again welcoming us as a media partner for the European conference. It has been a pleasure to share coverage before and during the event, and we look forward to continuing these important conversations in the months ahead.

If you would like to collaborate with us to raise awareness or share thought leadership around topics discussed at the conference, please get in touch. And as we look ahead to 2026, reach out to Dionne Basterfield to explore how The Evidence Base can support your visibility, engagement, and coverage opportunities throughout the year. Some of the conferences you can expect to see the team at include:

• World Evidence, Pricing and Access Congress Europe 2026 (March 3–4, 2026, Amsterdam, the Netherlands)
• ISPOR 2026 (May 17–20, 2026, Philadelphia, USA)
• International Society for Pharmacoepidemiology (ISPE) 42nd Annual Meeting (August 29 – September 2, 2026, Milan, Italy)
• ISPOR Europe 2026 (November 8–11, 2026, Vienna, Austria)