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Mossialos, Elias

Elias Mossialos is Brian Abel-Smith Professor of Health Policy, and Director of LSE Health. He is also Head of the Health Teaching Cluster at the Department of Social Policy at the London School of Economics and Political Science (LSE).

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, pharmaceutical policies, access to medicines in developing countries, private health insurance and the impact of EU law on health care systems. 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, articles in peer-review journals (in economics, political science, public policy, and health policy and economics) and book chapters.

In 1996 he founded LSE Health, which is currently LSE's largest research centre with 60 staff. The Centre was honoured with the prestigious Queen's Anniversary Prize in 2009, which is awarded biennially in recognition of outstanding achievement and excellence in UK universities and colleges. Uniquely in the field of education, the Prize sits within the national honours system. 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 was the 2002 and 2007 recipient of the Baxter Award from the European Health Management Association for the best publication in health policy and management in Europe.

In the 2008 UK Research Assessment Exercise (RAE), the Centre's staff accounted for 25% of the submission of the LSE's Department of Social Policy, which has ranked first in its field in the UK in equivalent evaluations since 1996. The Centre's reserve fund of approximately £1.5 million is used to fund doctoral and post-doctoral students. Since 2004 the Centre has contributed £600,000 from 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 Centre's dedication to combining technical competence with policy mindedness runs through its research, partnerships and networks. It is also an essential element of its postgraduate programmes, which train future generations of leaders in health care.

In 1998, Professor Mossialos co-founded the European Observatory on Health Systems and Policies, a major health policy research and knowledge transfer programme and 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 salaries), the Veneto Region of Italy, the 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 makes a key contribution to cross-national comparative analysis in two ways: it lays the groundwork for others to engage in comparative analysis and it produces award-winning comparative analyses of its own. The Observatory's health system profiles are internationally recognised for their innovative approach, their rigour and their comprehensive scope. The Observatory also produces policy briefs, which summarise key research findings in an accessible format to inform policy-makers. An important part of the Observatory's work is organising 'policy dialogues' with ministries of health in Europe. These bring together high-level policy-makers to debate specific policy issues with international experts. The Observatory is widely acknowledged as a unique success story in knowledge development and transfer and a potential model for national decision-making in low- and middle-income countries.

Professor Mossialos is also co-director of the European Observatory on the Social Situation, set up by the European Commission in 2005 to analyse social and demographic trends. His LSE based research team reports on key health and social care policy challenges and produces research and policy briefs to assist the Commission. His work on a major EU project on health status and living conditions also feeds into the work of the EC's Social Protection Committee and the development of health system performance indicators.

In April 2010 Professor Mossialos was appointed by the Greek Prime Minister Chairman of the Management Board of The Institute of Advanced Studies A. Papandreou. The Institute is a think tank for political research and public policy analysis. 

Professor Mossialos is a Fellow of the Faculty of Public Health (FFPH) and of the Royal College of Physicians (FRCP), and Honorary Consultant in Public Health with the South East London NHS Strategic Health Authority. He is 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. He edits the Cambridge University Press Health Economics, Policy and Management book series and co-edits an Open University Press book series on Health Care Systems. He is co-editor in chief of Health Economics, Policy and Law, a journal published by Cambridge University Press, and editor in chief of the Health Systems in Transition reports published by WHO. He chairs the editorial board of Globalization and Health. In 1995 he founded Eurohealth, a quarterly health policy journal, to cover the middle ground between academic scholarship and policy-making.

He has been an active participant in policy debates, advising the World Health Organization, the European Parliament, the European Commission, the World Bank, the 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 has been a member of the management board of the European Medicines Agency (2000-2003) and has contributed to the work of the International Forum on 'Common access to health care services' co-ordinated by the health ministers of Sweden, the UK and New Zealand.

He was invited by the Russian government and the Russian State Duma to review pharmaceutical policy in Russia during the economic crisis in 1998. His recommendations led to significant savings for the government, enabling it to finance additional pharmaceutical care. Professor Mossialos 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. This led to services better able to respond to local patient needs. He has twice been invited by the Belgian government (in 2001 and 2008) to undertake groundbreaking analysis of the impact of EU law and governance on health systems. The most recent analysis was presented at a high-level conference in Brussels in 2008 attended by ministers of health from Belgium, Germany, Spain, Hungary and Luxembourg. This work has made a significant contribution to raising awareness among policy makers of the often subtle but important ways in which EU law can affect national autonomy in the area of health care. In 2007 he was invited by the Finnish government to review pharmaceutical policies in Finland. His review recommended stronger incentives for doctors and pharmacists to prescribe and dispense appropriate and good quality medicines and policies to improve patient information and resource allocation. Most of the report's recommendations were implemented and have led to significant improvements in pharmaceutical care. In 2008 his work formed the centre-piece of a high-level symposium for US policy-makers in Washington DC following the presidential elections in 2008. This was attended by senior US government officials, advisers to then President-elect Obama's transition team and several ministers of health from other countries. He was invited to organise the Commonwealth Fund's International Symposium on Health Systems (to be attended by several Ministers of Health) in Washington, DC in November 2010. He has advised the Austrian Association of Health Insurance Funds on physician incentives, quality of health care and pharmaceutical policies. He has also recently completed a review of public health policies in Austria which will be published by WHO in September 2010.

His work (with Sarah Thomson) on private health insurance and health system financial sustainability has influenced debate about the interaction between public and private finance in EU health systems among several European Commission (EC) directorates (Employment and Social Affairs, Internal Market, Competition and Sanco) and fed into the work of the European Parliament's Committee on Employment and Social Affairs and the EC's Social Protection Committee.

In November 2007 he gave the keynote speech at a conference organised by the Korean Ministry of Health and the Korean Health Review Agency to celebrate 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 advised the Prime Minister and several ministers of the Republic of Kazakhstan on social policy developments (higher education, health and social assistance reforms).

In 2009 he produced a major report on antibiotics for the 2009 Swedish Presidency of the Council of the European Union. The lack of new antibiotics on the market forces physicians to prescribe a limited set of antibiotics, increasing the risks of antibiotic resistance, which some argue is a growing worldwide problem. The report proposed new incentive mechanisms based on a call options model to stimulate research and development. The research triggered the following impact:

  • a recommendation from the Swedish government in 2009 to the Council of the European Union (EU) to debate and issue a decision on antibiotics development in 2010;
  • a proposal put forward by the Swedish government following discussion with United States government officials in December 2009 to establish a transatlantic (US-EU) commission on antibiotics research and to push for US legislation.

In 1999, he established the MSc in International Health Policy at LSE, which has attracted high quality students from more than 90 countries. In 2009 he established a modular MSc in Health Economics, Policy and Management, Europe's only modular MSc in the field.  The MSc has been designed to meet the needs of mid-career professionals who seek formal qualifications in health economics, policy and management but do not have the flexibility to participate in a traditional MSc program. His teaching at the LSE reflects his research interests as outlined above. Elias teaches the following courses at Masters level:

SA 407 Financing health care
SA 4D4 Measuring health systems performance
SA 427 Pharmaceutical Economics and Policy
SA 4F6 Pharmaceutical Economics and Policies in Developing Countries 

Thesis titles of recent successful students

  •  Examining aspects of equity in Canada's health system
  •  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 recent publications

  1.  Mossialos E., Permanand P., Baeten R., Hervey T.H. (eds) (2010), Health Systems Governance in Europe: The Role of EU Law and Policy. Cambridge: Cambridge University Press.
  2.  Thomson S., Mossialos E. (eds) (2011 forthcoming), Private health insurance: history, politics, performance, Cambridge: Cambridge University Press.
  3.  Smith P.C., Mossialos E., Papanicolas I., Leatherman S.(eds) (2010 forthcoming), Performance Measurement for Health System Improvement: Experiences, Challenges and Prospects. Cambridge: Cambridge University Press.
  4. Thomson S., Foubister T., Mossialos E. (2010) Can user charges make health care more efficient? BMJ  ; 341:c3759
  5. Hernandez-Quevedo C., Masseria C., Mossialos E. (2010). Methodological issues in the analysis of the socioeconomic determinants of health using EU-SILC data. Luxembourg: Eurostat.
  6. Hernandez-Quevedo C., Masseria C., Mossialos E. (2010). Analysing the socioeconomic determinants of health in Europe: new evidence from the EU-SILC. Luxembourg: Eurostat.
  7. Morel CM, Mossialos E. Stoking the antibiotic pipeline. BMJ. 2010 May 18;340:c2115 
  8. Costa-Font J., Mossialos E., Rudisill C. Optimism and the perceptions of new risks. Journal of Risk Research 2009;12(1):27-41.
  9.  Allin, S., Masseria, C., Mossialos, E. (2009) Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income. American Journal of Public Health, 99(10):1849-1855.
  10.  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.
  11.  Mossialos E., Rudisill C. Knowledge about Avian Influenza in the European Region. Emerging Infectious Diseases 2008;14(12):1956-57.
  12.  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.
  13.  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.
  14.  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.
  15.  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.
  16.  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.
  17.  Mladovsky P., Mossialos E., McKee M. Improving access to research data in Europe. BMJ 2008;336:287-288.
  18.  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.
  19.  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.
  20.  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.
  21.  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.
  22.  Brogan D., E Mossialos E. Applying the Concepts of Financial Options to Stimulate Vaccine Development. Nature Reviews: Drug Discovery 2006;5:641-647.
  23.  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.
  24.  Permanand G, Mossialos E. Constitutional asymmetry and pharmaceutical policy-making in the European Union. Journal of European Public Policy 2005;12(4):687-609.
  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.
  26.  Mossialos E, Allin S, Davaki K. Analysing the Greek health system: a tale of fragmentation and inertia. Health Economics 2005;14(S1):S151-S168.
  27.  Foubister T, Thomson S, Mossialos E, McGuire A. Private medical insurance in the United Kingdom. Copenhagen: Copenhagen: World Health Organization, 2005.
  28.  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.
  29.  Petmesidou M, Mossialos E (eds) Social Policy Developments in Greece: A halfway house reform. Aldershot: Ashgate. 2005.
  30.  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.
  31.  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.
  32.  Mossialos E, Allin S M. Interest groups and health system reform in Greece. West European Politics 2005; 28(2):421-444.
  33.  King D, Mossialos E. The Determinants of Private Medical Insurance Prevalence in England. Health Services Research 2005; 40(1):195-212.
  34.  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.
  35.  Mossialos E, Walley T, Rudisill C. Provider incentives and prescribing in Europe. Expert Review of Pharmacoeconomics & Outcomes Research 2005; 5(1):81-93.
  36.  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.
  37.  Mossialos E, Mrazek M, Walley T. (eds) Regulating pharmaceuticals in Europe: striving for efficiency, equity and quality. Buckingham: Open University Press, 2004.
  38.  Mossialos E, Thomson S. Voluntary health insurance in the European Union. Copenhagen: World Health Organisation, 2004.
  39.  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.
  40.  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.
  41.  Bhatia M, Mossialos E. Health Systems in Developing Countries. In Hall A. and Midgley J. (eds) Social Policy for Development. London: Sage, 2004.
  42.  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.
  43.  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.
  44.  Mrazek M, Mossialos E. Stimulating pharmaceutical research and development for neglected diseases. Health Policy 2003;64(1):75-88.
  45.  Mossialos E, Thomson S, Access to health care in the European Union. In Gulliford M and Morgan M (eds) Access to health care. London: Rutledge, 2003.
  46.  Mossialos E, McKee M. The influence of EU Law on the social character of health care systems. Brussels: P.I.E. Peter Lang, 2002.
  47.  Mossialos E, Dixon A, Figueras J and Kutzin J (eds) Funding health care: Options for Europe. Buckingham: Open University Press, 2002 (Winner of the 2002 European Health Management Association's Baxter Award. Commended: BMA 2002 Book Competition).
  48.  Mossialos E, Thomson S. Voluntary Health Insurance in the EU: a critical assessment. International Journal of Health Services, 2002;32(1):19-88.

Affiliation

London School of Economics, Department of Social Policy

The interests of staff in the Department of Social Policy at the LSE embrace virtually all major issues which confront individual countries and the world today. The issues we cover include health, social services, education, social security, housing, crime and criminal justice, youth policy and...

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