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Professor Elias Mossialos

Elias Mossialos is Brian Abel-Smith Professor of Health Policy within the Department of Social Policy at the London School of Economics and Political Science (LSE), 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 currently 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 public policy, health policy and economics and political science.

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. The Prize 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 NHS Consultant in Public Health (South East London NHS Strategic Health Authority). He is a Visiting Professor at the Harris School of Public Policy, University of Chicago and Affiliate Professor at the Imperial College Business School. He is also an Honorary Professor at the University of Copenhagen, the London School of Hygiene & Tropical Medicine, and L'Ecole des Hautes Etudes en Santé Publique in France. Professor Mossialos is a member of ASPHER's Honours Committee, the World Health Organization’s (WHO) European Advisory Committee on Health Research, 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, associate editor (health policy) of the Journal Health Systems and Reform and associate editor (health policy) of  the European Heart Journal - Quality of Care & Clinical Outcomes. In 1995 he founded Eurohealth, a quarterly health policy journal bridging academic scholarship and policy-making, and since 1998 has been editor in chief of the Health Systems in Transition reviews published by WHO.

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 to 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 for research, development, and dissemination of 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.

He is currently advising the Development Research Council of the State Council in China on pharmaceutical policy reform.

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. The Centre also fosters the training of young researchers and is funding several doctoral and post-doctoral students; since 2004, the Centre has contributed more than £1.1 million 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 European Commission, the World Bank, the Governments of Belgium, Finland, Ireland, Norway, Slovenia, 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. The Observatory 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.

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:

SA4N4 Financing health care: comparative perspectives
SA 427 Pharmaceutical Economics and Policy

SA 407 Financing health care

Selected publications

Renwick M, Brogan D, Mossialos E. A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics. Journal of Antibiotics 2015 (in press).

Salas-Vega S., Haimann A., Mossialos E. Big data and healthcare: Challenges and opportunities for coordinated policy development in the EU. Health Systems and Reform (in press)

Wenzl M, McCuskee S, Mossialos E. Commissioning for equity in the NHS: rhetoric and practice Br Med Bull. 2015 (in press)

Morel CM, McClure L Edwards S, Goodfellow V, Sandberg D, Mossialos E. Ensuring innovation in diagnostics for bacterial infection: implications for policy. Copenhagen: World Health Organization, 2015

Carter A, Darzi A, Mossialos E A National Incident Reporting and Learning System in England and Wales, but at what Cost? Expert Review of Pharmacoeconomics & Outcomes Research 2015;15(3):365-8.

Mossialos E, Naci H, Courtain E et al. Form ‘retailers/ to health care providers: transforming the role of community pharmacists in chronic disease management. Health Policy 2015;119(5):628-39

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

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

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

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

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. 

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., 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. 

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. 

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

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. 

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., 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. 

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. 

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. 

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

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. 

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. 

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.

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.

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

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

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

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.

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, 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.

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.

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

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

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

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

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