The focus of healthcare assessments has conventionally been more on clinical and cost-efficiency of interventions. However, this tapered focus might overlook the aspects that contribute to meaningful health outcomes among individuals. The emerging concept of “Whole Health” highlights a wider, person-centred perspective of health that goes beyond physical well-being to include behavioural, emotional, social, economic, and spiritual aspects. “Whole Health” signifies a rising consensus that value in healthcare must be taken in the context of people’s lived experiences, not only through clinical parameters, but through their ability to live well.[1, 2]
This paradigm shift reflects in ISPOR’s Strategic Plan 2030,[3] that puts forth the concept of accessible, affordable, and more comprehensive healthcare that defines and delivers value.[3, 4] Inspired by the WHO’s renewed perspective on health as “a resource for everyday life, not the objective of living,”[5] ISPOR too identifies health as a comprehensive resource to advance HEOR. Consequently, assessments of health interventions must integrate a broader and more demonstrative belief of health aligning with the “Whole Health” paradigm.[2]
In reality, Whole Health value assessment integrates five basic elements: it is “people-centred, comprehensive and holistic, upstream focused, equitable and accountable, and grounded in well-being.”[2] These factors define a framework where individuals, families, communities, and healthcare systems strive together to create ‘value’. An intervention’s efficacy is not reviewed only in clinical parameters but by its ability to enhance a person’s daily life, cultivate emotional and spiritual flexibility, and minimize socioeconomic challenges. Notably, the concept of “Whole Health” promotes the incorporation of clinical, behavioural, and social care systems, all working collectively to focus on the overall health demands.[2]
The ”Whole Health” concept also encourages a more interdependent approach for generating evidence, including patient-reported outcomes (PROs), real-world data (RWD), and context-based narratives that depict different definitions of health as experienced by individuals and communities.[6] Therefore, the true health value can be assessed with components like therapeutic relationship, the patient’s personhood, and the clinician’s humanity. In Whole Health, well-being is not just the absence of disease, but the presence of a goal of contently living life and functionality, combining both hedonic (happiness-driven) and eudaimonic (meaning-driven) aspects of health.[2]
Whole Health value assessments have significant impact on HEOR in that they broaden the scope of what is evaluated, how it is measured, and whose viewpoints are prioritized.[2] By aligning with ISPOR’s strategic goals,[3] Whole Health value assessments lead more rigorous, relevant, and unbiased evaluations that represent the complexities of ever-changing modern healthcare. Whole Health also encourages stakeholders to redefine healthcare success not only by measuring disease control or economic savings, but by evaluating the quality of life lived.[1, 2, 6]
Whole Health value assessments encourage to perceive ‘value’ not only in the intervention, but also in its significance to what individuals sincerely need and care about. By doing so, they provide a more effective and more justified basis for healthcare decision-making globally.
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References
1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Committee on Transforming Health Care to Create Whole Health: Strategies to Assess, Scale, and Spread the Whole Person Approach to Health; Meisnere M, South-Paul J, Krist AH, editors. Achieving Whole Health: A New Approach for Veterans and the Nation. Washington (DC): National Academies Press (US); 2023 Feb 15. 2, Defining Whole Health. Available from: https://www.ncbi.nlm.nih.gov/books/NBK591719/
2. Pizzi LT, Abbott RM, Onukwugha E. Taking Health Economics and Outcomes Research Forward: Expanding the Definition of Value to Include Whole Health. Value Health. 2025; 28(5):702-704.
3. ISPOR. Strategic Plan 2030. 2024. Available online at: https://www.ispor.org/heor-resources/news-top/news/view/2024/07/29/ispor-announces-new-strategic-plan-2030
4. Walker J. ISPOR’s new strategic plan underscores importance of accessible, effective, efficient, and affordable global health care. Becaris Publishing. 2024. Available online at: https://becarispublishing.com/digital-content/blog-post/ispor-s-new-strategic-plan-underscores-importance-accessible-effective-efficient-and
5. WHO. Health Promotion. Available online at: https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference
6. Westritch K. “Whole Health” Value Assessment: Universal Survey Framework for Integrating Patient Experience Data in Health Technology Assessment. National Pharmaceutical Council. 2024. Available online at: https://www.ispor.org/docs/default-source/intl2024/ispor-whole-health-value-assessment-slidesmerged.pdf?sfvrsn=4a5a66ac_0
Health systems have developed at different speeds, and with differing degrees of complexity throughout the twentieth century, reflecting the diverse political and social conditions in each country. Notwithstanding their diversity, all systems, however, share a common reason for their existence, namely the improvement of health for their entire populations. To attain this goal a health system undertakes a series of functions, most notably, the financing and delivering of health services.