ISPOR’s 2026–2027 Top HEOR Trends highlight the growing role of AI, real-world evidence, and value-based healthcare

ISPOR—The Professional Society for Health Economics and Outcomes Research’s latest Top 10 Health Economics and Outcomes Research (HEOR) Trends Report examines how AI, real-world evidence (RWE), value-based healthcare, and related policy and methodological developments are expected to shape global healthcare decision-making over the next two years.

The 2026–2027 edition brings together perspectives from across the international HEOR community to identify where evidence requirements and decision-making expectations are evolving most rapidly. Drawing on input from researchers, regulators, payers, health technology assessment (HTA) bodies, and health system leaders, the report reflects both accelerating innovation and heightened scrutiny of how evidence is generated, evaluated, and applied in practice.

Published biennially as part of ISPOR’s horizon scanning and trend monitoring activities, this sixth edition was developed through a structured survey of ISPOR stakeholders. Topics curated by ISPOR’s Science Officers and Health Science Policy Council were rated by respondents, capturing global input from HEOR thought leaders to prioritize the issues viewed as most important for the upcoming two-year period.

The 2026–2027 Top 10 HEOR trends

The report identifies the following trends for the 2026–2027 period:

1. AI
2. Real-World Evidence
3. Value-Based Healthcare
4. Drug Pricing
5. Innovative Therapies
6. Patient Centricity
7. Relevance of HEOR
8. Health Technology Assessment
9. Value Measurement
10. Digital Health

AI ranks as the top trend (#1) in the 2026–2027 report, rising from #3 in the previous edition. ISPOR attributes this shift to the rapid expansion of AI across healthcare and research activities, including biopharma development, evidence synthesis, and HEOR workflows.

The report highlights AI’s potential to accelerate systematic literature reviews, structure complex datasets, and support advanced predictive analyses. At the same time, it underscores the importance of governance and oversight, noting that “human oversight is essential to ensure that AI-generated insights truly serve patients’ best interests,” particularly as automated use of large-scale data increases.

Announcing the report on LinkedIn, ISPOR CEO Rob Abbott stated that:

“AI is now embedded across the evidence lifecycle, from literature review and data structuring to predictive modeling and communication of insights,”

while stressing the need for “strong governance, transparency and human oversight to ensure accuracy, trust and patient-centered decision-making.”

RWE appears at #2, after ranking first in recent editions. ISPOR notes that while RWE use continues to expand across regulatory, payer, and HTA settings, attention is shifting from data access to robustness, transparency, and reproducibility. As RWE becomes more routinely embedded in decision-making, the report frames the next phase as one centered on methodological rigor and confidence in real-world insights.

Abbott echoed this perspective on LinkedIn, noting that as RWE becomes more central to regulatory and HTA decisions:

“The focus is shifting from access alone to data quality, transparency and methodological rigor – the foundations of confidence in real-world insights.”

Sandipan Bhattacharjee, Chair of ISPOR’s RWE Special Interest Group, described the ranking as reflecting “an evolving landscape where AI and RWE are increasingly interdependent,” with AI accelerating the generation and interpretation of real-world data and raising expectations for evidence quality.

Value-based healthcare (VBHC) ranks #3, marking its first appearance in ISPOR’s Top 10 list. While the concept is not new, ISPOR links its growing prominence to increasing financial and operational pressures on health systems globally.

The report cites NEJM Catalyst, defining VBHC as “a healthcare delivery model in which providers, including hospitals and physicians, are paid based on patient health outcomes.” ISPOR positions HEOR as essential to putting this model into practice. As payment and adoption decisions shift from service volume to patient outcomes, there is growing demand for strong clinical, economic, and patient-reported evidence to support these decisions.

Dr Sara Al Dallal, President of the Emirates Health Economics Society, echoed this view, saying the report reflects a shift toward “a more complex, data-intensive, and value-driven era.” She noted that VBHC is “moving from concept to implementation,” alongside AI and RWE, highlighting HEOR’s role in supporting innovation, access, and the long-term sustainability of health systems.

Beyond the top three, drug pricing ranks #4, reflecting ongoing affordability pressures and limited transparency. As the report notes:

“One of the key challenges impacting drug pricing continues to be a lack of price transparency in many markets,”

a factor that has contributed to increasing government involvement in pricing policy.

Innovative therapies return at #5, with the report noting that many new treatments, particularly in rare diseases, “find it difficult to gain market access due to payers and HTA bodies seeking data above and beyond what regulators require for approval.”

Patient centricity rises to #6, driven by expanding regulatory guidance and wider use of digital tools, such as wearables, to capture patient-generated health data. ISPOR frames this as a shift from studying patients to partnering with them across the evidence lifecycle.

A new entry at #7 is the relevance of HEOR, which ISPOR frames as increasingly critical as decision-making becomes more complex. As the report states:

“The only resource that can help make sense of the volume of complex data needed to make the best possible decisions are the insights provided by HEOR.”

HTA appears at #8, with renewed emphasis on cross-country collaboration, including joint assessments and shared approaches to managing uncertainty. Value measurement ranks #9, highlighting broader definitions of value that extend beyond clinical outcomes to include “whole health,” which ISPOR defines as considering “all aspects of a person’s life—including physical, mental, social, financial, environmental, and spiritual factors.” Digital health completes the list at #10, with ISPOR pointing to digital therapeutics, wearables, and AI-enabled tools as growing sources of real-world data and patient engagement.