We were delighted to have a team of 13 colleagues attend ISPOR 2026 in Philadelphia this May, where we came together with other global healthcare leaders, researchers and decision makers to explore the theme of “HEOR at the Forefront of Policy, Access and Value”.
We enjoyed sharing some recent company updates with attendees, including our experience with Joint Clinical Assessment (JCA), the recent expansion of our Canadian HEOR and Access Services and our work relating to the potential for technical innovation and artificial intelligence (AI) to facilitate advances in HEOR. In addition, we were pleased to contribute a podium presentation and 4 research posters of our own to the conference. Explore all of our published research.
ISPOR 2026 exposed a growing tension between commercial momentum and best practice guidelines in AI-assisted literature reviews. A growing commercial ecosystem is marketing AI-assisted literature reviews, with platforms and vendors claiming dramatic efficiency gains with no negative impact on quality, but leading guidance and early evidence reveal a more complex landscape.
ISPOR’s Good Practices Task Force on GenAI for systematic literature reviews warns that full end-to-end automation is not yet appropriate; outcomes are heterogeneous and there is no universal endorsement. Costello Medical’s own research on efficiency gains, together with a recent Nature opinion piece, suggests caution about how much time AI really saves in literature reviews if high quality is to be maintained. Health Technology Assessment, regulatory and governance hurdles persist, including unclear copyright licensing and no HTA precedent for fully AI-assisted literature reviews.
In this article we explore whether ethical, high-quality AI-assisted literature reviews are possible and where HTA bodies and publishers fit in.
ISPOR 2026 made it clear: the US healthcare market is facing a phase of more, rather than less uncertainty.
As IRA implementation stabilises, a wave of new overlapping policies, from GLOBE and GUARD to GENEROUS and MFN, is reshaping how manufacturers think about pricing and launch strategies. However, pricing is only part of the story. Growing access barriers, driven by tighter prior authorisation, utilisation management and intermediary influence, are creating a widening gap between approvals and patient access.
The conversation has shifted from preparing for reform to managing its real-world consequences. The key question now is whether the US can navigate mounting policy complexity without undermining the innovation and access it values.
At ISPOR 2026, the MFN drug pricing agenda and pharmaceutical innovation surfaced as interconnected issues. An issue panel on dynamic efficiency raised a question that the health economics literature has examined but that rarely shapes pricing policy: how much social surplus from a pharmaceutical innovation should accrue to the innovator to maintain the pipeline?
One framework presented at the conference argues that dynamic efficiency is achieved when innovators capture near-full surplus during exclusivity, with consumer surplus accruing after generic entry. This exposes a global free-rider problem that MFN, framed as a trade policy reallocating who funds global R&D, purports to address. But will peer countries raise reimbursement, or will manufacturers withdraw from low-priced markets and undercut the policy? And can a single benchmark price ever reflect the different ways countries value health?
Rare disease research has a persistent evidence challenge and one of the clearest themes from ISPOR 2026 was the sector’s growing belief that new data sources may help close that gap.
Social media listening, wearable sensors, natural language processing and data-derived comparator groups are opening new ways to identify patients and capture outcomes that traditional studies often miss. But the more important question raised at ISPOR 2026, to be explored in this article, was not whether we can generate more data, but whether we can generate evidence that decision-makers can trust.
HEOR is entering a truly global era, where evidence, policy and access decisions are increasingly interconnected across markets. ISPOR 2026 highlighted China (and other Asian market)’s rise as a strategic hub for evidence generation, with growing potential to support both local and global decision-making—particularly in areas like rare diseases. At the same time, the expanding role of real-world evidence in China demonstrates an opportunity for shared learning across geographies facing similar challenges: delivering the right evidence, at the right time, to meet evolving payer expectations.
For industry, this shift demands a more coordinated, forward-looking approach – embedding generalisability into study design, aligning cross-market strategies and investing in robust evidence generation capabilities. In this article, we explore how in this connected landscape, evidence is no longer local – it is a global strategic asset requiring careful planning and prioritisation.
Two ISPOR 2026 sessions discussed critical considerations in the evolution of evidence generation and synthesis, shining a spotlight on the significance of this topic.
An issue panel on the estimand framework emphasised the need to define precise research questions and data collection prospectively, particularly for patient-reported outcomes and tolerability endpoints, where analytical discipline has historically been inconsistent. A separate workshop on multivariate methods demonstrated how bivariate network meta-analysis, multi-state models and composite treatment-ranking frameworks can synthesise evidence across multiple endpoints simultaneously to describe patient-centric outcomes.
Together, these sessions illuminate a shared challenge: the field has increasingly sophisticated tools for evidence generation and synthesis, yet their validity rests on an assumption of conceptual comparability across trials that heterogeneous estimands may undermine.
