EXECUTIVE SUMMARY

For the first time, ISPOR’s Top 10 HEOR Trends list includes value-based healthcare (VBHC), ranking it #3 for 2026–2027. While VBHC itself isn’t new, its re-emergence as a top-tier priority signals something important: the conversation is shifting from theory to implementation.

Health systems are no longer debating whether value-based models make sense. They’re grappling with how to operationalize them in an environment defined by cost pressure, workforce constraints, and increasingly complex therapies.

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WHY VBHC IS RISING NOW

ISPOR points to several converging forces driving VBHC back into focus: rising healthcare costs, labor shortages, and demand that outpaces system capacity. These pressures are forcing payers and providers to ask harder questions about what “value” actually means—and how to pay for it.

At the same time, global policy momentum continues to favor outcomes over volume. From CMS pay-for-performance programs in the US to international efforts to standardize outcomes measurement, incentives are increasingly aligned around results, not utilization.

The implication is clear: value-based healthcare is no longer a pilot concept.

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WHERE HEOR AND MARKET ACCESS INTERSECT

ISPOR underscores the central role of HEOR in making VBHC workable. In this model, reimbursement is tied to outcomes beyond efficacy, including economic burden and humanistic benefit.

That puts pressure on manufacturers to demonstrate value in ways that resonate with real-world decision-makers:

• How does a therapy perform outside controlled trials?

• What are the downstream cost or resource implications?

• How does it affect patient experience and system efficiency?

For market access teams, this means evidence strategies must evolve beyond traditional cost-effectiveness narratives to address implementation realities—such as site-of-care considerations, operational burden, and care pathway disruption.

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THE MISSING LINK: IMPLEMENTATION COSTS AND TRADE-OFFS

One of ISPOR’s most practical insights is that VBHC cannot succeed without acknowledging the full cost of adoption. That includes factors often overlooked in traditional assessments—staff time, infrastructure requirements, storage, wastage, and throughput constraints.

As more advanced and high-cost therapies enter the market, these “hidden” costs increasingly influence access decisions. Health technology assessment bodies are beginning to factor them in, reframing value as a system-level equation rather than a product-level one.

This is where access strategy and HEOR must work in lockstep.

WHAT THIS MEANS FOR LIFE SCIENCES LEADERS

VBHC’s return to the spotlight isn’t new, but it brings greater accountability in today’s budget-driven era.

Manufacturers that succeed in this environment will be those that:

• Anticipate implementation barriers

• Align evidence generation with payer and provider workflows

• Treat value as something demonstrated across the care continuum

ISPOR’s inclusion of VBHC as a top trend reflects a system under strain, and a growing expectation that innovation must deliver measurable, sustainable impact.‍

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LOOKING AHEAD

As value-based healthcare moves from aspiration to execution, the definition of “value” will continue to broaden and scrutiny will intensify.

For companies preparing for 2026 and beyond, the message is clear: value is no longer declared; it’s demonstrated, operationalized, and continuously reassessed.

And in that environment, evidence that connects outcomes to real-world delivery will matter more than ever.

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‍Kristen Cribbs is VP of Value and Access at Alkemi, where she helps life sciences teams build payer-ready evidence strategies for launch and beyond.