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Professor Elias Mossialos

Elias Mossialos is Brian Abel-Smith Professor of Health Policy at the Department of Social Policy at the London School of Economics and Political Science, and Director of LSE Health. His research interests concentrate on health policy relating to health care systems. His particular focus is European and comparative health systems and policy, addressing questions related to funding health care, private health insurance, pharmaceutical policies, the impact of EU law on health care systems, and access to medicines in developing countries. His work has been translated into Japanese, Russian, Greek and Spanish. He is internationally recognised for his comparative work on health care financing and his research on EU law and governance.

He is currently examining approaches to stimulating research for neglected diseases based on the concept of a financial call option. He is also analysing incentives to address the need for sufficient investment in the development of antibiotics in order to meet changing medical needs. He has more than 200 publications, including books, book chapters and articles in peer-review journals in the fields of economics, political science, public policy and health policy.

Professional honours and awards

In 2010 he was awarded the Andrija Stampar medal by the Association of Schools of Public Health in Europe (ASPHER) and the European Public Health Association (EUPHA), for contributions to European public health. He received the 2002 and 2007 Baxter Awards from the European Health Management Association for the best publication in health policy and management in Europe. In 2002 he received a Commended Prize in the BMA Medical Book Competition.

In 2009, under his directorship, LSE Health and Social Care was honoured with the biennial Queen's Anniversary Prize for Higher and Further Education. It recognises outstanding achievement and excellence in UK universities and colleges and sits within the national honours system.

Professor Mossialos is a Fellow of the Faculty of Public Health (FFPH) and Fellow of the Royal Colleges of Physicians of London and Edinburgh, and Honorary Consultant in Public Health. He is an Honorary Professor at the University of Copenhagen, the London School of Hygiene & Tropical Medicine (LSHTM), Imperial College and L'Ecole des Hautes Etudes en Santé Publique in France. He is also a member of ASPHER's Honours Committee, the World Health Organization’s (WHO) European Advisory Committee on Health Research and the Access to Medicine Index’s Expert Review Committee. He is a Member of the Health, Demographic Change and Well-being Advisory Group for the Horizon 2020 Research Programme of the European Commission, the Scientific Advisory Board of the research centre UC-CARE at the University of Copenhagen and the International Advisory Board of the Peking University International Hospital.

Editorial positions

Professor Mossialos edits the Health Economics, Policy and Management book series published by Cambridge University Press and co-edits the Health Care Systems book series published by Open University Press. He is co-editor in chief of Health Economics, Policy and Law, a peer-review journal published by Cambridge University Press, associate editor (health policy) of Health Systems and Reform and editor in chief of the Health Systems in Transition reports published by WHO. In 1995 he founded Eurohealth, a quarterly health policy journal bridging academic scholarship and policy-making.

Policy involvement and impact

Professor Mossialos has advised the WHO, European Parliament, European Commission (EC), World Bank, UK Office of Fair Trading, Ministries of Health and Social Affairs in Belgium, Brazil, China, Cyprus, Finland, Greece, Ireland, Kazakhstan, Russia, Slovenia, South Africa, Spain and Sweden, and health insurance funds in Austria, Croatia, France, Hungary and South Korea. He was a member of the management board of the European Medicines Agency (2000-2003) and the board of the Hellenic National Medicines Agency (2000-2002) and contributed to the International Forum on 'Common access to health care services' co-ordinated by the health ministers of Sweden, the UK and New Zealand. His advisory activities have included two key areas:

a) Pharmaceutical policy

In 1998, Professor Mossialos was invited by the Russian government and State Duma to review pharmaceutical policy in Russia during the economic crisis, leading to significant savings for the government which then financed additional pharmaceutical care.

In 2007 he was invited by the Finnish government to review its pharmaceutical policies. He recommended stronger incentives for doctors and pharmacists to prescribe and dispense appropriate, quality medicines, and policies to improve patient information and resource allocation. This led significant improvements in pharmaceutical care, the Medicines Policy 2020 document being jointly adopted by the government and the pharmaceutical industry, and the establishment of a new centralised agency www.fimea.fi|) for research, development, and dissemination in pharmaceuticals.

In 2009 he produced a major report on antibiotics for the 2009 Swedish Presidency of the Council of the European Union (EU). The report analysed how the lack of new antibiotics on the market forces physicians to prescribe a limited set of antibiotics, increasing the risk of antibiotic resistance, and proposed new incentives for research and development based on a call options model. Impacts included a recommendation from the Swedish government in 2009 to the Council of the EU to debate and issue a decision on antibiotics development in 2010 and a proposal by the Swedish government, after discussion with US officials, to establish a transatlantic (US-EU) commission on antibiotics research and push for US legislation.

b) Health insurance policy and health systems

Professor Mossialos was invited in 2001 and 2008 by the Belgian government to analyse the impact of EU law and governance on health systems. His work was presented at a high-level conference in Brussels in 2008 attended by ministers of health from Belgium, Germany, Spain, Hungary and Luxembourg and has made a significant contribution to raising awareness among policy makers of how EU law can affect national autonomy in the area of health care. He has advised the Austrian Association of Health Insurance Funds on physician incentives, quality of health care and pharmaceutical and public health policies, in 2010.

In November 2007 he gave the keynote speech at a conference organised by the Korean Ministry of Health and the Korean Health Review Agency upon the 30th anniversary of the establishment of social health insurance in Korea. In December 2007 he advised the government of China on health insurance reforms and coverage decisions and in February 2008 he advised the Prime Minister of the Republic of Kazakhstan on higher education, health and social assistance reform policy.

His work (with Sarah Thomson) on private health insurance and health system financial sustainability has influenced debate in several EC directorates, the EC's Social Protection Committee, and the European Parliament's Committee on Employment and Social Affairs.

Professor Mossialos was the coordinator of the International Committee of Experts (chaired by the late Professor Brian Abel-Smith) invited by the Prime Minister of Greece to review the Greek health system in 1994. The Committee produced an influential report on reorganising the Greek National Health System (B. Abel-Smith, J. Calltorp, M. Dixon, Ad. Dunning, R. Evans, W. Holland, B. Jarman, E. Mossialos, Report on the Greek Health Services. Athens: Ministry of Health, June 1994). He also made a major contribution to the Greek government's White Paper on the decentralisation of health services and development of regional health authorities in 2001.

Research centres and major research initiatives

LSE Health

In 1996 Professor Mossialos founded LSE Health, currently LSE's largest research centre with 60 staff working on a wide range of research, combining technical competence with policy mindedness. In the 2008 UK Research Assessment Exercise, the Centre's staff accounted for 25% of the submission by the LSE's Department of Social Policy, ranked first in its field in the UK since 1996. The Centre also fosters the training of young researchers through a reserve fund of approximately £1.5 million for funding doctoral and post-doctoral students; since 2004, the Centre has contributed a further £700,000 of its own funds to support its PhD students. In 2009 the LSE's Research Committee highlighted the Centre's PhD programme and postdoctoral support systems as “exemplary”.

The European Observatory on Health Systems and Policies

In 1998, Professor Mossialos co-founded the European Observatory on Health Systems and Policies, a major health policy research and knowledge transfer programme. The Observatory is a partnership between the World Health Organization (Regional Office for Europe), the World Bank, the European Investment Bank, the Governments of Belgium, Finland, Ireland, The Netherlands, Norway, Slovenia, Spain and Sweden, the French National Health Insurance Fund (Caisse nationale de l'assurance maladie des travailleurs salariés), the Veneto Region of Italy, LSE and LSHTM.  He is currently Co-Director of the Observatory. It supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health care systems in Europe. The Observatory produces internationally recognised country health system reports and policy briefs, and organises 'policy dialogues' with ministries of health in Europe.

The European Observatory on the Social Situation (2005-2012)

Professor Mossialos was Co-Director of the European Observatory on the Social Situation, set up by the European Commission in 2005 to analyse social and demographic trends, which produces research reports and policy briefs to aid the EC’s decision-making on health system and social care policy issues.

Hellenic Observatory

Professor Mossialos coordinated the LSE Fundraising Committee (1993-96) to establish the Hellenic Observatory and the Eleftherios Venizelos Chair of Contemporary Greek Studies at the LSE European Institute, and served as the Acting Director of the Hellenic Observatory from 1996-98.

Teaching contributions and innovations

Professor Mossialos established the MSc in International Health Policy at LSE in 1999, which has attracted high quality students from more than 90 countries, and in 2009 a modular MSc in Health Economics, Policy and Management, Europe's only modular MSc in the field, directed at mid-career professionals who lack the flexibility to participate in a traditional MSc programme. In 2014, in cooperation with the European Society of Cardiology, he established a modular MSc in Health Economics, Outcomes and Management. In 2014 he also established an interdisciplinary MSc in Global Health.

Professor Mossialos teaches the following courses at master’s level:

SA 407 Financing health care
SA 427 Pharmaceutical Economics and Policy

Recent Keynote and distinguished lectures

  • Health policy-innovating for longevity, Swiss Re Annual Conference, Zurich, 22 October 2012
  • Bending the cost curve: Priorities and strategies in high income countries for containing costs, 15th International Symposium on Health Care Policy, The Commonwealth Fund, Washington D.C., 14 November 2012
  • The role and implementation of HTA in CEE countries, National Assembly, Sofia, Bulgaria, 29 November 2012
  • Health Sector Performance, The 3rd Lecture of the Supreme Health Council, Qatar, Distinguished Lecture Series, Doha, 22 January 2013
  • New contractual models for coordinating outpatient chronic care, Caisse Nationale de l’Assurance Maladie (French National Health Insurance Fund), Paris, 31 January 2013
  • The affordability of the health care system: looking into the future, European Society of Cardiology, 20th Anniversary Conference, Nice, 6 March 2013
  • The role of community pharmacists in caring for people with multiple chronic conditions: A cross-national comparison, The Commonwealth Fund 16th International Symposium on Health Policy, Washington, D.C., 13-15 November 2013. 
  • Pharmaceutical Cost-Containment Policies in Europe: challenges and pitfalls. Development Research Centre of the State Council, Beijing, 11th April 2014.
  • Ethical issues related to health economics, Clinical Ethics Open Day organised by the Clinical Ethics Committee of the Imperial College Healthcare NHS Trust (ICHT) and the UK Clinical Ethics Network, Hammersmith Hospital, 20th May 2014.

Thesis titles of recent PhD students

  • Examining aspects of equity in Canada's health system
  • Generating Comparative Data on Clinical Benefits and Harms of Statins to Inform Prescribing Decisions: Evidence from Network Meta-Analyses
  • Social capital and enrolment in community-based health insurance in Senegal
  • Voluntary health insurance and health system performance in the European Union
  • 'The New NHS': Financial Incentives for Quality? 
  • Toward Effective Health Technology Regulation
  • Decision-making under risk. The case of adolescent smoking 
  • Non-adherence to medication: The impact of the doctor-patient relationship 
  • General Practitioners' prescribing decision-making: the case of proton pump inhibitors in France 
  • The politics of health insurance reform in Korea: institutions, policy networks and policy outputs  
  • Welfare arrangements, safety nets and familial support for the elderly in Portugal 
  • The impact of differing regulatory frameworks on post-patent pharmaceutical markets in the UK, US and Germany (1990-1997) 
  • Regulating under constraint: the case of EU pharmaceutical policy 
  • An analysis of the government-industry relationship in the British pharmaceutical price regulation scheme

Selected publications

EU law and policy and health systems governance

Mossialos E, Lear J. Balancing economic freedom against social policy principles: EC competition law and national health systems. Health Policy 2012;106(2): 127-138. 

Mossialos E., Permanand P., Baeten R., Hervey T.H. (eds). Health Systems Governance in Europe: The Role of EU Law and Policy. Cambridge: Cambridge University Press, 2010. 

Permanand G, Mossialos E, McKee M. The EU’s new paediatric medicines. Archives of Disease in Childhood 2007; 92:808-811

Thomson S, Mossialos E. Regulating private health insurance in the European Union: the implications of single market legislation and competition policy. Journal of European Integration 2007;29(1): 89-107. 

Permanand G, Mossialos E. Constitutional asymmetry and pharmaceutical policy-making in the European Union. Journal of European Public Policy 2005;12(4):687-609.

Mossialos E, Palm W. The European Court of Justice and the Free Movement of Patients in the European Union. International Social Security Review 2003;56(2):3-29.

Mossialos E, McKee M. The influence of EU Law on the social character of health care systems. Brussels: P.I.E. Peter Lang, 2002.

Financing health care

Thomson S., Foubister T., Mossialos E. Can user charges make health care more efficient? BMJ 2010; 341:c3759. 

Mladovsky P., Mossialos E. A Conceptual Framework for Community-Based Health Insurance in Low-Income Countries: Social Capital and Economic Development, World Development 2008;36(4):590-607. 

Gemmil M., Thomson S., Mossialos E. What impact do prescription drug charges have on equity and efficiency? Evidence from high-income countries. International Journal for Equity and Health 2008;7:12. 

Thomson S., E Mossialos E. Choice of public or private health insurance: learning from the experience of Germany and the Netherlands. Journal of European Social Policy 2006;16(4): 315-327.

Foubister T, Thomson S, Mossialos E, McGuire A. Private medical insurance in the United Kingdom. Copenhagen: Copenhagen: World Health Organization, 2005.

King D, Mossialos E. The Determinants of Private Medical Insurance Prevalence in England. Health Services Research 2005; 40(1):195-212.

Mossialos E, Thomson S. Voluntary health insurance in the European Union. Copenhagen: World Health Organisation, 2004.

Mossialos E, Dixon A, Figueras J and Kutzin J (eds) Funding health care: Options for Europe. Buckingham: Open University Press, 2002

Mossialos E, Thomson S. Voluntary Health Insurance in the EU: a critical assessment. International Journal of Health Services, 2002;32(1):19-88.

Pharmaceutical policy

Mossialos E, Naci H, Courtain E. Expanding the role of community pharmacists: Policymaking in the absence of policy-relevant evidence? Health Policy 2013;111(2):135-48

Morel CM, McGuire A, Mossialos E. The level of income appears to have no consistent bearing on pharmaceutical prices across countries. Health Aff (Millwood). 2011;30(8):1545-52. 

Sorenson C, Naci H, Cylus J, Mossialos E. Evidence of comparative efficacy should have a formal role in European drug approvals. BMJ. 2011;343:d4849. doi: 10.1136/bmj.d4849. 

Mossialos E., Srivastava D. Pharmaceutical policies in Finland: Challenges and opportunities. Ministry of Health and Social Affairs (Finland) and European Observatory on Health Systems and Policies. Copenhagen: World Health Organization, 2008. 

Mossialos E., D Brogan D. T Walley T. Pharmaceutical pricing in Europe: Weighing up the Options. International Social Security Review 2006;59(3):3-25.

Walley T, Mrazek M, Mossialos E. Regulating Pharmaceutical Markets: improving efficiency and controlling costs in the UK. International Journal in Health Planning and Management 2005;20(4):375-98.

Mossialos E, Walley T, Rudisill C. Provider incentives and prescribing in Europe. Expert Review of Pharmacoeconomics & Outcomes Research 2005; 5(1):81-93.

Mossialos E, Mrazek M, Walley T. (eds) Regulating pharmaceuticals in Europe: striving for efficiency, equity and quality. Buckingham: Open University Press, 2004.

Papanicolaou S, Sykes D, Mossialos E, The EMEA and the Evaluation of Health-Related Quality of Life Data in Drug Regulatory Processes. International Journal for Technology Assessment in Health Care 2004;20(3): 311-324.

Incentives to develop vaccines and antibiotics

Brogan D, Mossialos E. Incentives for new antibiotics: the Options Market for Antibiotics (OMA) Model. Globalization and Health 2013, 9:58  doi:10.1186/1744-8603-9-58

Mossialos E, Morel CM, Edwards S, Berenson J, Gemmill-Toyama M, Brogan D. Policies and Incentives for Promoting Innovation in Antibiotic Research. Copenhagen: World Health Organization, 2010

Morel CM, Mossialos E. Stoking the antibiotic pipeline. BMJ. 2010 May 18;340:c2115. 

Brogan D., E Mossialos E. Applying the Concepts of Financial Options to Stimulate Vaccine Development. Nature Reviews: Drug Discovery 2006;5:641-647.

Mrazek M, Mossialos E. Stimulating pharmaceutical research and development for neglected diseases. Health Policy 2003;64(1):75-88.

Health systems research

Courtin E,  Jemiai N, Mossialos E Mapping support policies for informal carers across the European Union. (with E Health Policy, 2014 (in press)

Stabile M, Thomson S, Allin S, Boyle S, Busse R, Chevreul K, Marchildon G, Mossialos E. Containing health care costs in high-income countries: evidence from four nations. Health Affairs Health Aff (Millwood). 2013;32(4):643-52

Smith P.C., Mossialos E., Papanicolas I., Leatherman S.(eds). Performance Measurement for Health System Improvement: Experiences, Challenges and Prospects. Cambridge: Cambridge University Press, 2010. 

Merkur S, M Long M, McKee M, Mossialos E Physician revalidation in Europe. (with) Clinical Medicine, 2008;8(4):371-376.

Mossialos E, Allin S, Davaki K. Analysing the Greek health system: a tale of fragmentation and inertia. Health Economics 2005;14(S1):S151-S168.

Allin S, Davaki K, Mossialos E. Informal Payments in Central and Eastern Europe and the Commonwealth of Independent States. In Transparency International. Global Corruption Report 2006. London: Pluto

Oliver A, Mossialos E. Health System Reform in Europe: looking back to see forward? Journal of Health Policy Politics and Law 2005:30(1-2):7-28.

Mossialos E, Allin S M. Interest groups and health system reform in Greece. West European Politics 2005; 28(2):421-444.

Davaki K, Mossialos E. Plus ça change: health sector reforms in Greece. Journal of Health Policy, Politics and Law 2005:30(1-2):143-168.

Oliver A, Mossialos E. Equity of access to health care: outlining the foundations for action. J of Epidemiol and Community Health 2004;58(8): 655-658.

Bhatia M, Mossialos E. Health Systems in Developing Countries. In Hall A. and Midgley J. (eds) Social Policy for Development. London: Sage, 2004.

Oliver A, Mossialos E, Robinson R. Priority setting and health technology assessment. International Journal of Technology Assessment in Health Care 2004;20(1):1-10.

Mossialos E, Thomson S, Access to health care in the European Union. In Gulliford M and Morgan M (eds) Access to health care. London: Routledge, 2003.

Health services research and risk research

Ali FMH, Nikoloski Z, Reka H, Gjebrea O, Mossialos E. The diabetes-obesity-hypertension nexus in Qatar: evidence from the World Health Survey Population Health Metrics 2014;12:18 (28 August 2014)

Nikoloski Z, Mossialos E. Corruption, inequality and population perception of healthcare quality in Europe BMC Health Services Research 2013, 13:472  doi:10.1186/1472-6963-13-472

Kossarova L., Holland W., Mossialos E. 'Avoidable' mortality: a measure of health system performance in the Czech Republic and Slovakia between 1971 and 2008. Health Policy and Planning 2013;28(5):508-25

Rudisill C., Costa-Font J., Mossialos E. Behavioral adjustment to avian flu in Europe during spring 2006: the roles of knowledge and proximity to risk, Social Science and Medicine 2012; 75 (8):1362-1371.   

Boluarte T. A., Mossialos E., Rudisill C. The impact of alcohol policies across Europe on young adults' perceptions of alcohol risks. CESifo economic studies, 2011;57 (4): 763-788

Hernandez-Quevedo C., Masseria C., Mossialos E. Methodological issues in the analysis of the socioeconomic determinants of health using EU-SILC data. Luxembourg: Eurostat, 2010. 

Hernandez-Quevedo C., Masseria C., Mossialos E. Analysing the socioeconomic determinants of health in Europe: new evidence from the EU-SILC. Luxembourg: Eurostat, 2010. 

Costa-Font J., Mossialos E., Rudisill C. Optimism and the perceptions of new risks. Journal of Risk Research 2009;12(1):27-41. 

Allin, S., Masseria, C., Mossialos, E. Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income. American Journal of Public Health, 2009;99(10):1849-1855. 

Mossialos E., Rudisill C. Knowledge about Avian Influenza in the European Region. Emerging Infectious Diseases 2008;14(12):1956-57. 

Costa-Font J., Rudisill C., Mossialos E. Attitudes as an Expression of Knowledge and 'Political Anchoring': The Case of Nuclear Power and Radioactive Waste in the UK. Risk Analysis 2008;28(5):1273-1288. 

Mossialos E., Costa-Font J., Rudisill, C. Does organ donation legislation affect individuals' willingness to donate their own or their relative's organs? Evidence from European Union survey data. BMC Health Services Research 2008;8:48doi. 

Hirte L., Nolte E., Mossialos E., McKee M. The changing regional pattern of ischaemic heart disease mortality in southern Europe: still health but uneven progress. J Epidemiol Community Health 2008;62:e4. 

Mladovsky P., Mossialos E., McKee M. Improving access to research data in Europe. BMJ 2008;336:287-288. 

Costa-Font J, Mossialos E. Are Perceptions of Risk and Benefits of Genetically Modified Food Independent? Food Quality and Preference 2007;18(2):173-182. 

Al-Moosa S, Allin S, Jemiai N, Al-Lawati J, Mossialos E, Diabetes and urbanization in the Omani population: an analysis of national survey data. Population Health Metrics, 2006; 24;4(1):5.

Costa-Font J, Mossialos E. 'Ambivalent' Individual Preferences towards Biotechnology in the European Union: Products or Processes? Journal of Risk Research 2005;8(4):341-54.

Mossialos E, Allin S, Karras K, Davaki K. An investigation of Caesarean sections in three Greek hospitals. Eur J Public Health 2005 15:288-295.